King, Samantha Y

King, Samantha Y is an individual health care provider with primary practice located at 1627 Seymour Dr , South Boston VA 24592-3447. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. King, Samantha Y can be contacted via phone (434) 575-1336.

Contact Information

Primary practice address
1627 Seymour Dr South Boston VA 24592-3447
Phone: (434) 575-1336
Fax: (434) 575-1349
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101234104 Virginia

Profile Details

NPI number 1639147739
LBN Legal business name King, Samantha Y
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jan 31st, 2020 - about 4 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 1639147739 NPPES
Virginia MEDICAID 006738567
Virginia Other 62490
Virginia Other 246295

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