Sampson, Jerome M
Sampson, Jerome M is an individual health care provider with primary practice located at 3000 32Nd Ave S , Fargo ND 58103-6132. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Sampson, Jerome M can be contacted via phone (701) 364-8000.Contact Information
Primary practice address
3000 32Nd Ave S
Fargo ND 58103-6132
Phone: (701) 364-8000
Fax: (701) 364-8078
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 4703 | North Dakota |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 4703 | North Dakota |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 4703 | North Dakota |
Profile Details
| NPI number | 1487681599 |
|---|---|
| LBN Legal business name | Sampson, Jerome M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Jul 18th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487681599 | NPPES |
| North Dakota | Other | 1600852 | MEDICA FGO # |
| North Dakota | MEDICAID | 14146 | MEDICA FGO # |
| North Dakota | Other | 9258 | MEDICA FGO # |
| North Dakota | Other | DA9011015581 | MEDICA FGO # |
| North Dakota | Other | HP25764 | MEDICA FGO # |
| North Dakota | MEDICAID | 634208600 | MEDICA FGO # |
| North Dakota | Other | 676650 | MEDICA FGO # |
| North Dakota | Other | 974 | MEDICA FGO # |
| North Dakota | Other | 1600853 | MEDICA FGO # |
| North Dakota | Other | 91427SA | MEDICA FGO # |
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