Provider Demographics
NPI:1205148939
Name:PURCELL-MATTHEW, SAMANGER NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:SAMANGER
Middle Name:NICOLE
Last Name:PURCELL-MATTHEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMANGER
Other - Middle Name:NICOLE
Other - Last Name:PURCELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:751 PLEASANT ROW NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-2537
Mailing Address - Country:US
Mailing Address - Phone:256-533-6311
Mailing Address - Fax:256-536-0801
Practice Address - Street 1:751 PLEASANT ROW NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-2537
Practice Address - Country:US
Practice Address - Phone:256-533-6311
Practice Address - Fax:256-536-0801
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.31946174400000X
AL31946208M00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist