Miranda Sam

NPI #1639957624 in Sartell, Minnesota

Provider Information

NPI Number: 1639957624
Entity Type: Individual
Name: Miranda Sam
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Sep 20, 2023
Last Updated: Sep 20, 2023

Practice Location

Address: 1801 AMBER AVE S
City: Sartell
State: Minnesota
ZIP Code: 56377-7507
Phone: (218) 287-4338

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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