Provider Demographics
NPI:1922471234
Name:SAMS, CHRISTIN (MMS, PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:
Last Name:SAMS
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 PEACHTREE RD NE STE 700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1417
Mailing Address - Country:US
Mailing Address - Phone:678-732-1389
Mailing Address - Fax:404-352-7452
Practice Address - Street 1:3200 DOWNWOOD CIR NW STE 700
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-5308
Practice Address - Country:US
Practice Address - Phone:678-732-1389
Practice Address - Fax:404-352-7452
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
GA007801363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant