Individual provider · Type 1 NPI
Samuel Fenderson
Surgical Physician Assistant · Stone Mountain, GA
NPI number
1326370545
Active
Practice location
925 Main St # 300-07
Stone Mountain, GA 30083-3098
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Assistant | 246ZC0007X | None listed |
| Surgical Physician Assistant Primary | 363AS0400X | None listed |
Surgical Physician Assistant: Definition to come...
About NPI 1326370545
Samuel Fenderson's National Provider Identifier is 1326370545, issued on Feb 12, 2010. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Stone Mountain, GA. The record was last updated on Mar 1, 2018.