Oldham, Samuel Dewayne

Oldham, Samuel Dewayne is an individual health care provider with primary practice located at 224 W. D.L. Ingram Ave, Bldg 1408 , Cannon Afb NM 88103. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Oldham, Samuel Dewayne can be contacted via phone (575) 904-3917.

Contact Information

Primary practice address
224 W. D.L. Ingram Ave, Bldg 1408 Cannon Afb NM 88103
Phone: (575) 904-3917
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1980 Alabama

Profile Details

NPI number 1043517089
LBN Legal business name Oldham, Samuel Dewayne
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2011
Last updated Feb 21st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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