Basic Information
| Provider Information | |||||||||
| NPI: | 1982615134 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAMS | ||||||||
| FirstName: | HUNTER | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 E 18TH AVE | ||||||||
| Address2: | DENVER SKIN CLINIC | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802061205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033227789 | ||||||||
| FaxNumber: | 3033220221 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 E 18TH AVE | ||||||||
| Address2: | DENVER SKIN CLINIC | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802061205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033227789 | ||||||||
| FaxNumber: | 3033220221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 04/17/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 42754 | CO | Y | Allopathic & Osteopathic Physicians | Dermatology |
ID Information
| ID | Type | State | Issuer | Description | BS8932712 | 01 | DEA | OTHER |