Stafford, Sam
Stafford, Sam is an individual health care provider with primary practice located at 570 Long Point Rd Suite 200, Mt Pleasant SC 29464-7930. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Stafford, Sam can be contacted via phone (843) 881-0320.Contact Information
Primary practice address
570 Long Point Rd Suite 200
Mt Pleasant SC 29464-7930
Phone: (843) 881-0320
Fax: (843) 881-5453
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | 570943516 | South Carolina |
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 08579 | South Carolina |
Profile Details
NPI number | 1164480166 |
---|---|
LBN Legal business name | Stafford, Sam |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 2nd, 2006 |
Last updated | Oct 24th, 2012 - about 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1164480166 | NPPES |
South Carolina | MEDICAID | 085794 |
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