Individual provider · Type 1 NPI
Samuel Pennella Jr., MD
General Practice Physician · Detroit, MI
NPI number
1124524038
Active
Practice location
607 Shelby St Ste 700
Detroit, MI 48226-3282
Mailing address
14 Glennon Farm Ln
Lebanon, NJ 08833-4504
Other practice locations
- 14 Glennon Farm Ln, Lebanon, NJ 08833-4504 · (908) 208-8926
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician | 208D00000X | 68449 (MN) |
| General Practice Physician | 208D00000X | TW00059 (KS) |
| General Practice Physician | 208D00000X | TPME2986 (FL) |
| General Practice Physician | 208D00000X | DR.0074417 (CO) |
| General Practice Physician Primary | 208D00000X | 4301510893 (MI) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
2 other providers at this address
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About NPI 1124524038
Samuel Pennella Jr., MD's National Provider Identifier is 1124524038, issued on Apr 2, 2018. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Detroit, MI. The record was last updated on May 6, 2026.