Fort, Samuel L.

Fort, Samuel L. is an individual health care provider with primary practice located at 203B Mocksville Ave , Salisbury NC 28144-3325. He recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as his primary health care specialty. Fort, Samuel L. can be contacted via phone (704) 636-0971.

Contact Information

Primary practice address
203B Mocksville Ave Salisbury NC 28144-3325
Phone: (704) 636-0971
Fax: (704) 636-8854
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X 9501242 North Carolina

Profile Details

NPI number 1841254166
LBN Legal business name Fort, Samuel L.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Jul 8th, 2007 - about 18 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 1841254166 NPPES
Other 33148 BCBS
MEDICAID 8933148 BCBS

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