Provider Demographics
NPI:1134159866
Name:SAMS, SHELI MILAM
Entity type:Individual
Prefix:
First Name:SHELI
Middle Name:MILAM
Last Name:SAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHELI
Other - Middle Name:
Other - Last Name:MILAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1001 N HALSTEAD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3121
Mailing Address - Country:US
Mailing Address - Phone:228-818-0416
Mailing Address - Fax:228-818-4932
Practice Address - Street 1:1001 N HALSTEAD RD
Practice Address - Street 2:SUITE B
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3121
Practice Address - Country:US
Practice Address - Phone:228-818-0416
Practice Address - Fax:228-818-4932
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16922207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSH35424Medicare UPIN
MS160000468Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.