Provider Demographics
NPI:1477226801
Name:SAMSON, MARGARET DOYLE (MS)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:DOYLE
Last Name:SAMSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 PITMAN ST # 3
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4022
Mailing Address - Country:US
Mailing Address - Phone:520-780-8497
Mailing Address - Fax:
Practice Address - Street 1:44 PITMAN ST # 3
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4022
Practice Address - Country:US
Practice Address - Phone:520-780-8497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86120027133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered