Provider Demographics
NPI:1477686608
Name:SEPLOW, M SAMSON (DO)
Entity Type:Individual
Prefix:
First Name:M
Middle Name:SAMSON
Last Name:SEPLOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:MERYL
Other - Middle Name:STACEY
Other - Last Name:SEPLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:954 CHELTEN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-1501
Mailing Address - Country:US
Mailing Address - Phone:215-885-1647
Mailing Address - Fax:
Practice Address - Street 1:1423 TILTON RD STE 6
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1857
Practice Address - Country:US
Practice Address - Phone:609-697-7933
Practice Address - Fax:609-772-4850
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0136112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry