Provider Demographics
NPI:1659506517
Name:KYERE, SAMPSON K JR (MD)
Entity Type:Individual
Prefix:
First Name:SAMPSON
Middle Name:K
Last Name:KYERE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4061 POWDER MILL RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CALVERTON
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3149
Mailing Address - Country:US
Mailing Address - Phone:202-669-8501
Mailing Address - Fax:240-846-1490
Practice Address - Street 1:1415 ELBRIDGE PAYNE RD STE 120
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-8522
Practice Address - Country:US
Practice Address - Phone:314-238-5260
Practice Address - Fax:314-821-1833
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2023-08-15
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Provider Licenses
StateLicense IDTaxonomies
MDD00716892085R0202X, 2085R0204X
TN599972085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology