Provider Demographics
NPI:1285731299
Name:FLOYD, SAMUEL STEVEN JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:STEVEN
Last Name:FLOYD
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:11010 S TRYON ST
Mailing Address - Street 2:STE. 108
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-0106
Mailing Address - Country:US
Mailing Address - Phone:704-583-1155
Mailing Address - Fax:704-504-2495
Practice Address - Street 1:11010 S TRYON ST
Practice Address - Street 2:STE. 108
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-0106
Practice Address - Country:US
Practice Address - Phone:704-583-1155
Practice Address - Fax:704-504-2495
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-05-20
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Provider Licenses
StateLicense IDTaxonomies
NC103440363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP57020Medicare UPIN