Provider Demographics
NPI:1548289846
Name:SAMSON, DAVID R (MD, DLFAPA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:SAMSON
Suffix:
Gender:M
Credentials:MD, DLFAPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 DENALI ST
Mailing Address - Street 2:SUITE 606
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2746
Mailing Address - Country:US
Mailing Address - Phone:907-276-2978
Mailing Address - Fax:
Practice Address - Street 1:2600 DENALI ST
Practice Address - Street 2:SUITE 606
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2746
Practice Address - Country:US
Practice Address - Phone:907-276-2978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK11672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKC97225Medicare UPIN