Provider Demographics
NPI:1649202706
Name:GIVEEN, SAMUEL C (OD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:C
Last Name:GIVEEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DUNNING ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2016
Mailing Address - Country:US
Mailing Address - Phone:603-543-0320
Mailing Address - Fax:603-543-0570
Practice Address - Street 1:9 DUNNING ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2016
Practice Address - Country:US
Practice Address - Phone:603-543-0320
Practice Address - Fax:603-543-0570
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH730152W00000X
ME857152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME094003801NH02OtherANTHEM BLUE CROSS BLUE SH
NH30353060Medicaid
ME94141161OtherCIGNA
NH094003801NH01OtherANTHEM BLUE CROSS BLUE SH
NHNH579684OtherCIGNA
ME94141161OtherCIGNA
NH5386830001Medicare NSC
U23781Medicare UPIN