Provider Demographics
NPI:1487814810
Name:DAVID B. SAMUELS, D.P.M.
Entity Type:Organization
Organization Name:DAVID B. SAMUELS, D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FILIPIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-747-7355
Mailing Address - Street 1:405 FREDERICK RD
Mailing Address - Street 2:SUITE 154
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4645
Mailing Address - Country:US
Mailing Address - Phone:410-747-7355
Mailing Address - Fax:410-747-0535
Practice Address - Street 1:405 FREDERICK RD
Practice Address - Street 2:SUITE 154
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4645
Practice Address - Country:US
Practice Address - Phone:410-747-7355
Practice Address - Fax:410-747-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4888030001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT283Medicare PIN