Provider Demographics
NPI:1346246600
Name:SAMUEL, STEVEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:SAMUEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PHEASANT RUN
Mailing Address - Street 2:SUITE 128
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3439
Mailing Address - Country:US
Mailing Address - Phone:215-860-3344
Mailing Address - Fax:215-860-8950
Practice Address - Street 1:1 UNION STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-4219
Practice Address - Country:US
Practice Address - Phone:609-890-6677
Practice Address - Fax:609-585-2520
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04561700207RC0000X
PAMD039170E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF06619OtherHEALTHNET #
NJ0347621000OtherAMERIHEALTH #
NJ4096985OtherAETNA HMO #
NJ43608OtherAETNA HMO #
NJ2147904Medicaid
NJ1104694OtherHORIZON NJ HEALTH #
NJMES160OtherOXFORD #
NJF06619OtherHEALTHNET #
NJ43608OtherAETNA HMO #
NJ2147904Medicaid
NJ075648AJZMedicare PIN