Provider Demographics
NPI:1841280401
Name:SAMPSON, CAROLYN M (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:M
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 US HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-7779
Practice Address - Country:US
Practice Address - Phone:919-739-4808
Practice Address - Fax:919-739-4810
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2021-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC32323207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8974367Medicaid
NC212696HMedicare Oscar/Certification
NC8974367Medicaid