Provider Demographics
NPI:1932867678
Name:GULINO, SAM PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:PAUL
Last Name:GULINO
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 1:2200 ARCH ST UNIT 901
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1344
Mailing Address - Country:US
Mailing Address - Phone:215-459-3508
Mailing Address - Fax:
Practice Address - Street 1:1900 MARKET ST FL 8
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-3527
Practice Address - Country:US
Practice Address - Phone:646-484-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD210001618207ZP0101X
PAMD433710207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology