Provider Demographics
NPI:1336303643
Name:CARLIN, SAM
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:CARLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27366 OAK DR
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-8826
Mailing Address - Country:US
Mailing Address - Phone:269-651-3362
Mailing Address - Fax:
Practice Address - Street 1:27366 OAK DR
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-8826
Practice Address - Country:US
Practice Address - Phone:269-651-3362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment