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Contact Information

SAMUEL W PERSON, DPM
2020 WAKEFIELD AVE
PETERSBURG, VA23805-2112
 Phone: 804-732-1211
 Fax: 804-733-5946
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Podiatric Medicine

213EP1101X 48 Podiatry
Indicates primary specialty

NPI Profile & details for SAMUEL W PERSON · (Male)

NPI # 1154324879
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 05/27/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • VA License # 0103000377
  • VA Medicaid 9331409
Hospital affiliation(s) Not Available
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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