Basic Information
| Provider Information | |||||||||
| NPI: | 1093268567 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAM | ||||||||
| FirstName: | SHEBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 829641 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191829641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673705296 | ||||||||
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| Practice Location | |||||||||
| Address1: | DOYLESTOWN HEALTH HOSPITALISTS | ||||||||
| Address2: | 595 W. STATE STREET | ||||||||
| City: | DOYLESTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153452885 | ||||||||
| FaxNumber: | 2153452552 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2016 | ||||||||
| LastUpdateDate: | 01/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN591219 | PA | N | Nursing Service Providers | Registered Nurse | 363LF0000X | SP016344 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.