Provider Demographics
NPI:1225143662
Name:SAMUEL S. NORVELL, M.D.
Entity Type:Organization
Organization Name:SAMUEL S. NORVELL, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:NORVELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-738-0047
Mailing Address - Street 1:9707 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE130
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3348
Mailing Address - Country:US
Mailing Address - Phone:301-738-0047
Mailing Address - Fax:301-738-1652
Practice Address - Street 1:9707 MEDICAL CENTER DR
Practice Address - Street 2:SUITE130
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3348
Practice Address - Country:US
Practice Address - Phone:301-738-0047
Practice Address - Fax:301-738-1652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035231207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG00528Medicare ID - Type Unspecified