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
Fax: (843) 881-5453
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1164480166 NPPES
South Carolina MEDICAID 085794

Popular Providers