Samp, Charles M

Samp, Charles M is an individual health care provider with primary practice located at 6242 E Arbor Ave Ste 111, Mesa AZ 85206-1309. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Samp, Charles M can be contacted via phone (480) 610-8183.

Contact Information

Primary practice address
6242 E Arbor Ave Ste 111 Mesa AZ 85206-1309
Phone: (480) 610-8183
Fax: (480) 895-3110
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1554 Arizona

Profile Details

NPI number 1538126545
LBN Legal business name Samp, Charles M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1538126545 NPPES
Arizona MEDICAID 578841

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