Provider Demographics
NPI:1144227620
Name:BRICKER, SAMUEL Q (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:Q
Last Name:BRICKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:144 S 8TH ST
Practice Address - Street 2:SUITE 111
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2767
Practice Address - Country:US
Practice Address - Phone:717-264-6511
Practice Address - Fax:717-264-1081
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2014-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD024325E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009928520001Medicaid
PA016333LN7Medicare PIN
PA0009928520001Medicaid