Provider Demographics
NPI:1902006794
Name:VENTURELLA, SAMUEL CAREY (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:CAREY
Last Name:VENTURELLA
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 1:1156 EDGEFIELD ST
Mailing Address - Street 2:UPPER SAVANNAH RADIOLOGIC ASSOCIATES
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646
Mailing Address - Country:US
Mailing Address - Phone:864-889-9605
Mailing Address - Fax:
Practice Address - Street 1:1156 EDGEFIELD ST
Practice Address - Street 2:UPPER SAVANNAH RADIOLOGIC ASSOCIATES
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646
Practice Address - Country:US
Practice Address - Phone:864-889-9605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMMD.36157TL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology