David L. Samuel, M.D. a Proffessional Medical Corporation

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

10711R Issued in LA

Legal business name

DAVID L. SAMUEL, M.D. A PROFFESSIONAL MEDICAL CORPORATION

Practice address

233 Saint Ann Dr
Suite 3
Mandeville, LA 70471-3395

Phone

(985) 624-6650

Fax

(985) 674-3634

NPI assigned

Jun 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. David L Samuel, M.D.

Title

M.D.

Phone

(985) 624-6650

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1497041008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 SAINT ANN DR",
            "address_2": "SUITE 3",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713395",
            "telephone_number": "985-624-6650",
            "fax_number": "985-674-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 SAINT ANN DR",
            "address_2": "SUITE 3",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713395",
            "telephone_number": "985-624-6650",
            "fax_number": "985-674-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L. SAMUEL, M.D. A PROFFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "985-624-6650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "LA",
            "license": "10711R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1991562",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Daniels
• Rebecca Guidry Dantone
• Shantee N. Darensburg, PHARM D
• Gabriel Ferdinand Daroca III, DDS
• Kim Dauzat, MS, CCC-SLP
• Anna Christine Davis, M.D.
• Harley Jacob Davis, MD
• Katlyn Dawson
• Paulette Dawson, LCSW
• DDMS of Louisiana No 2, LLC

• Medical Specialty Clinic/Center in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Medical Specialty Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.