Fenderson, Samuel

Fenderson, Samuel is an sole proprietor health care provider with primary practice located at 925 Main St # 300-07 , Stone Mountain GA 30083-3098. He recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Surgical Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Fenderson, Samuel can be contacted via phone (678) 799-2498.

Contact Information

Primary practice address
925 Main St # 300-07 Stone Mountain GA 30083-3098
Phone: (678) 799-2498
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant 246ZC0007X
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X

Profile Details

NPI number 1326370545
LBN Legal business name Fenderson, Samuel
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2010
Last updated Mar 1st, 2018 - about 6 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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