Mathew.P.Samuel,MD PSC

Primary specialty

SpecialistTaxonomy code 174400000X

License

30450 Issued in KY

Legal business name

MATHEW.P.SAMUEL,MD PSC

Practice address

2154 Carter Ave Ste D
Ashland, KY 41101-7739

Phone

(606) 325-9224

NPI assigned

Apr 23, 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. Mathew P Samuel, M.D

Title

President

Phone

(606) 325-9224

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1174741425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 CARTER AVE STE D",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017739",
            "telephone_number": "606-325-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 CARTER AVE STE D",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017739",
            "telephone_number": "606-325-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATHEW.P.SAMUEL,MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-325-9224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "30450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Melissa Jo Mavis, ARNP
• Amanda Rose Maxim, M.S., CCC-SLP

• Specialist in Ashland, KY
• Providers in Ashland, KY by specialty
• Specialist in Kentucky

• 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.