Mietling, Samuel W.
Mietling, Samuel W. is an individual health care provider with primary practice located at 2416 Dunn Avenue , Jacksonville FL 32218-1015. He recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Neuroimaging, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Mietling, Samuel W. can be contacted via phone (904) 353-3664.Contact Information
Primary practice address
2416 Dunn Avenue
Jacksonville FL 32218-1015
Phone: (904) 353-3664
Fax: (904) 353-3858
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 051686 | Georgia |
| Allopathic & Osteopathic Physicians / Diagnostic Neuroimaging | 2085D0003X | 051686 | Georgia |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 051686 | Georgia |
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | 051686 | Georgia |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | 051686 | Georgia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 051686 | Georgia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME49311 | Florida |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | ME49311 | Florida |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | 051686 | Georgia |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 051686 | Georgia |
Profile Details
| NPI number | 1750347589 |
|---|---|
| LBN Legal business name | Mietling, Samuel W. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 21st, 2006 |
| Last updated | May 23rd, 2024 - about 7 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750347589 | NPPES |
| Georgia | MEDICAID | 00952795C | |
| Georgia | MEDICAID | 00952795A | |
| Georgia | MEDICAID | 00952795B | |
| Georgia | Other | 1346357217 | |
| Georgia | Other | 83555 | |
| Georgia | MEDICAID | G51686 |
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