Provider Demographics
NPI:1558057851
Name:SAMUEL, ABIOLA (DO)
Entity Type:Individual
Prefix:
First Name:ABIOLA
Middle Name:
Last Name:SAMUEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 DENNY CIR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5926
Mailing Address - Country:US
Mailing Address - Phone:302-310-1128
Mailing Address - Fax:
Practice Address - Street 1:22 DENNY CIR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5926
Practice Address - Country:US
Practice Address - Phone:302-310-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program