Provider Demographics
NPI:1336296813
Name:SOCKWELL, SAM (MD)
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:SOCKWELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:224 MASSACHUSETTS AVE
Mailing Address - Street 2:APT # 43
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8436
Mailing Address - Country:US
Mailing Address - Phone:617-894-9113
Mailing Address - Fax:
Practice Address - Street 1:133 OLD ROAD TO 9 ACRE COR
Practice Address - Street 2:DEPT EMERGENCY MEDICINE EMERSON HOSPITAL
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4159
Practice Address - Country:US
Practice Address - Phone:978-287-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA72949207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine