Provider Demographics
NPI:1457617326
Name:RICHTER, SAMUEL MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:MICHAEL
Last Name:RICHTER
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 1:670 GLADES RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6464
Mailing Address - Country:US
Mailing Address - Phone:561-955-6663
Mailing Address - Fax:
Practice Address - Street 1:701 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2305
Practice Address - Country:US
Practice Address - Phone:561-955-4111
Practice Address - Fax:561-955-4894
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1304642085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology