Davis, Samuel R

Davis, Samuel R is an individual health care provider with primary practice located at 400 6Th Ave , Montgomery WV 25136-2117. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Davis, Samuel R can be contacted via phone (304) 442-5151.

Contact Information

Primary practice address
400 6Th Ave Montgomery WV 25136-2117
Phone: (304) 442-5151
Fax: (304) 442-1347
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 13914 West Virginia

Profile Details

NPI number 1902863954
LBN Legal business name Davis, Samuel R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902863954 NPPES
West Virginia MEDICAID 0117385000

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