Individual
SAMUEL INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125A LITTON HTS, SCOTT DEPOT, WV 25560-9741
(304) 553-5760
Mailing address
125A LITTON HTS, SCOTT DEPOT, WV 25560-9741
(304) 553-5760
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/07/2026
Last updated
08/07/2026
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