Provider Demographics
NPI:1730259698
Name:LYNESS, SAMUEL STEWART (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:STEWART
Last Name:LYNESS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2129 BEACH VILLAGE CT
Mailing Address - Street 2:T2
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-5501
Mailing Address - Country:US
Mailing Address - Phone:410-263-2423
Mailing Address - Fax:
Practice Address - Street 1:WRAMC, 6900 GEORGIA AVE, NW
Practice Address - Street 2:NEUROSURGERY SERVICE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-5001
Practice Address - Country:US
Practice Address - Phone:202-782-5123
Practice Address - Fax:202-782-0126
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD027324L207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA61844Medicare UPIN