Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. SAMUEL FENDERSON
Active Sole ProprietorMR. SAMUEL FENDERSON is a Surgical Physician Assistant healthcare provider located in STONE MOUNTAIN, Georgia. NPI 1326370545 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · STONE MOUNTAIN, GA
Registration Details
- NPI Number
- 1326370545
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 12, 2010 (16.543608975371 yrs)
- Last Updated
- Mar 1, 2018
- Sole Proprietor
- Yes
Practice Information
- Address
-
925 MAIN ST # 300-07STONE MOUNTAIN, GA, 300833098Browse GA providers · Browse ZIP 30083
- Phone
- 6787992498
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.