Provider Demographics
NPI:1457434987
Name:NAWFEL, SAM M (DO)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:M
Last Name:NAWFEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:45 FOREST FALLS DR STE A3
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6999
Mailing Address - Country:US
Mailing Address - Phone:207-846-3282
Mailing Address - Fax:207-846-3570
Practice Address - Street 1:45 FOREST FALLS DR STE A3
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6999
Practice Address - Country:US
Practice Address - Phone:207-846-3282
Practice Address - Fax:207-846-3570
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME1266204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME017650OtherANTHEM
MEMM2604Medicare ID - Type Unspecified
MEE37147Medicare UPIN