Provider Demographics
NPI:1225022643
Name:SAWYER, SAMUEL FLEMING (MD)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:FLEMING
Last Name:SAWYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:101 E BRUNSON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2500
Mailing Address - Country:US
Mailing Address - Phone:334-393-3212
Mailing Address - Fax:334-393-4979
Practice Address - Street 1:101 E BRUNSON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2500
Practice Address - Country:US
Practice Address - Phone:334-393-3212
Practice Address - Fax:334-393-4979
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12765208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051509768OtherBCBS
AL529912520Medicaid
AL051509768OtherBCBS
C70992Medicare UPIN