Provider Demographics
NPI:1083925523
Name:SAMUEL, ALEXANDER P (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:P
Last Name:SAMUEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:111 N SOUTH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-1354
Mailing Address - Country:US
Mailing Address - Phone:443-392-3984
Mailing Address - Fax:434-392-1038
Practice Address - Street 1:111 N SOUTH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1354
Practice Address - Country:US
Practice Address - Phone:443-392-3984
Practice Address - Fax:434-392-1038
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012474652083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine