Individual
SAMUEL G. AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
309 N MANGOUSTINE AVE UNIT G, SANFORD, FL 32771-1098
(321) 363-1754
(321) 363-3336
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
22674
SC
207XX0801X
Orthopaedic Trauma Physician
4301102465
MI
207XX0801X
Orthopaedic Trauma Physician
Primary
ME102967
FL
Other
Enumeration date
02/07/2006
Last updated
06/04/2020
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