Provider Demographics
NPI:1629028576
Name:BRITT, SAMUEL E II (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:E
Last Name:BRITT
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2934 N ELM ST
Practice Address - Street 2:STE E
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2986
Practice Address - Country:US
Practice Address - Phone:910-739-0022
Practice Address - Fax:910-739-0079
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25887208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8918516Medicaid
C81495Medicare UPIN
NCNCG693AMedicare PIN