Provider Demographics
NPI:1467673046
Name:SAMS, WINN P (DC)
Entity Type:Individual
Prefix:DR
First Name:WINN
Middle Name:P
Last Name:SAMS
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 1:1108 CHARLES ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-4501
Mailing Address - Country:US
Mailing Address - Phone:843-522-1115
Mailing Address - Fax:
Practice Address - Street 1:1108 CHARLES ST UNIT B
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-4501
Practice Address - Country:US
Practice Address - Phone:843-522-1115
Practice Address - Fax:843-379-5558
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3199111N00000X
SC4575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2456951Medicare UPIN