Provider Demographics
NPI:1720158553
Name:SAMPSON, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SAMPSON
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 1:2100 ERWIN RD
Mailing Address - Street 2:DUKE UNIVERSITY MEDICAL CENTER - DUMC 3050
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-9041
Mailing Address - Fax:919-684-9045
Practice Address - Street 1:2100 ERWIN RD
Practice Address - Street 2:DUKE UNIVERSITY MEDICAL CENTER - DUMC 3050
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-9041
Practice Address - Fax:919-684-9045
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-00716207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911353Medicare ID - Type Unspecified
G68597Medicare ID - Type Unspecified
NC2253415AMedicare ID - Type Unspecified