Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | VL89 | SC |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 4301023899 | MI |
NPI | 1679702419 |
---|---|
Provider Name | Dr. Louis Carl Samberg |
First Address | Cheboygan, MI 49721 |
Second Address | Cheboygan, MI 49721-9782 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2009 |
Last Update Date | 14/07/2009 |