Provider Demographics
NPI:1376814756
Name:SAMUELS, LINDA L (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:SAMUELS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 CHESWOLDE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3931
Mailing Address - Country:US
Mailing Address - Phone:443-955-3088
Mailing Address - Fax:443-288-4009
Practice Address - Street 1:2818 CHESWOLDE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3931
Practice Address - Country:US
Practice Address - Phone:443-955-3088
Practice Address - Fax:443-288-4009
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor