Samuel Chan, M.D.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

D36655 Issued in MD

Legal business name

SAMUEL CHAN, M.D.

Practice address

324 E Antietam St
Suite 200
Hagerstown, MD 21740-5754

Phone

(301) 797-8822

Fax

(301) 790-3748

NPI assigned

Oct 12, 2007

Last updated

Oct 12, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Samuel Chan, M.D.NPI 1972538841

Title

Medical Doctor

Phone

(301) 797-8822

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Chan, M.D.

  • Internal Medicine Physician
  • Hagerstown, MD
  • NPI 1972538841
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1043408230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST",
            "address_2": "SUITE 200",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405754",
            "telephone_number": "301-797-8822",
            "fax_number": "301-790-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST",
            "address_2": "SUITE 200",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405754",
            "telephone_number": "301-797-8822",
            "fax_number": "301-790-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL CHAN, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "301-797-8822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MD",
            "license": "D36655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ4601",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF D.C.",
            "identifier": "W111",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECROSS BLUES",
            "identifier": "KDZ2SA",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salvatore Dimercurio MD PA
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• Samer Saiedy MD PA (Maryland Vascular Specialists)
• Eric C Sampsell, MSPT
• Sams East Inc (Sams Pharmacy 10-8193)
• Laurie Sandberg, RN
• Hannah Sanders
• Diane Marie Sandy, FNP
• Chelsey Noelle Sanford, APRN
• Dinesh Sangroula, MD

• Community Health Worker in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Community Health Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.