Provider Demographics
NPI:1619396330
Name:CATER, SAMANTHA BLAIR DONALD (DO)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:BLAIR DONALD
Last Name:CATER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SAMANTHA
Other - Middle Name:BLAIR
Other - Last Name:DONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:929 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-3964
Mailing Address - Country:US
Mailing Address - Phone:423-892-0576
Mailing Address - Fax:
Practice Address - Street 1:2009 OLD LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742
Practice Address - Country:US
Practice Address - Phone:706-861-5950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA80428207V00000X
TN3469207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology