Provider Demographics
NPI:1073806865
Name:DONOHOE, SAMUEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:M
Last Name:DONOHOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-428-2500
Mailing Address - Fax:360-428-6485
Practice Address - Street 1:1415 E KINCAID ST
Practice Address - Street 2:HOSPITALISTS OFFICE
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4126
Practice Address - Country:US
Practice Address - Phone:360-416-5750
Practice Address - Fax:360-416-5758
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2014-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA120494207R00000X
WAMD60465597207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine