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Contact Information

SAMUEL D DETWEILER, MD
331 BRIDGE ST
ST. MARY'S HOSPITAL, NORTHVILLE FAMILY HEALTH CENTER
NORTHVILLE, NY12134
 Phone: 518-863-4200
 Fax: 518-863-4787
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SAMUEL D DETWEILER · (Male)

NPI # 1437299237
Status Active
Credentials MD
Entity Individual
Enumeration date 02/08/2007
Last updated 09/21/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 157873
  • NY Other 000419006006 BS PROVIDER NUMBER
  • NY Other 10000485 CDPHP
  • NY Other 040426006943 FIDELIS
  • NY Other 77787 MVP
Hospital affiliation(s)
  • NATHAN LITTAUER HOSPITAL - (Acute Care)
    99 EAST STATE STREET
    GLOVERSVILLE, NY 12078
  • ST MARY'S HOSPITAL AT AMSTERDAM - (Acute Care)
    427 GUY PARK AVENUE
    AMSTERDAM, NY 12010
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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