Individual
SAMUEL JOHN HUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 E PIONEER, PUYALLUP, WA 98372-3265
(253) 697-8400
(253) 697-3730
Mailing address
325 E PIONEER, PUYALLUP, WA 98372-3265
(253) 697-8400
(253) 697-3730
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
MD60620786
WA
2084P0800X
Psychiatry Physician
2004014337
MO
2084P0800X
Psychiatry Physician
258121
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03255194
—
NY
Enumeration date
02/13/2007
Last updated
02/26/2016
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