Samuelsen, Thomas

Samuelsen, Thomas is an individual health care provider with primary practice located at 1155 E Mountain Blvd , Wilkes Barre PA 18702-7906. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Samuelsen, Thomas can be contacted via phone (570) 808-7916.

Contact Information

Primary practice address
1155 E Mountain Blvd Wilkes Barre PA 18702-7906
Phone: (570) 808-7916
Fax: (570) 808-6006
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X MD043615L Pennsylvania
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD043615L Pennsylvania

Profile Details

NPI number 1467431858
LBN Legal business name Samuelsen, Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated Aug 10th, 2020 - about 6 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 1467431858 NPPES
Pennsylvania MEDICAID 001234828

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