Samuel, Prince D

Samuel, Prince D is an sole proprietor health care provider with primary practice located at 4221 Washington Ave , Evansville IN 47714-0675. He recently has only one registered license in Allopathic & Osteopathic Physicians / Retina Specialist, which is considered as his primary health care specialty. Samuel, Prince D can be contacted via phone (812) 476-6500.

Contact Information

Primary practice address
4221 Washington Ave Evansville IN 47714-0675
Phone: (812) 476-6500
Fax: (812) 476-6507
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 01057972A Indiana

Profile Details

NPI number 1295730299
LBN Legal business name Samuel, Prince D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2005
Last updated Apr 24th, 2017 - about 8 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 1295730299 NPPES
Indiana MEDICAID 200454280

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