NPI 1265026470 · live from the CMS NPI Registry
Samantha Marie Burrill, OD
Optometrist in South Portland, ME. National Provider Identifier 1265026470, active.
NPI record
| NPI | 1265026470 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 743 Broadway, South Portland, ME 04106 |
| Practice phone | 207-799-3031 |
| Enumerated | February 28, 2021 |
| Last updated | February 28, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | OPT1038 (ME) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.