Provider Demographics
NPI:1518725266
Name:FELIX, SAMSON M
Entity Type:Individual
Prefix:
First Name:SAMSON
Middle Name:M
Last Name:FELIX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 SEAMAN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-4907
Mailing Address - Country:US
Mailing Address - Phone:567-215-8658
Mailing Address - Fax:
Practice Address - Street 1:2227 SEAMAN ST APT 1
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-4907
Practice Address - Country:US
Practice Address - Phone:567-215-8658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty