Provider Demographics
NPI:1801850128
Name:SAMIES, JOHN HUNTER (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HUNTER
Last Name:SAMIES
Suffix:
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 1:2850 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-3156
Mailing Address - Country:US
Mailing Address - Phone:803-539-0505
Mailing Address - Fax:803-539-0410
Practice Address - Street 1:1097B COOK RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8209
Practice Address - Country:US
Practice Address - Phone:803-539-0505
Practice Address - Fax:803-539-0410
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19747207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT38652Medicaid
SCC29921Medicare UPIN
SC8402Medicare PIN