Provider Demographics
NPI:1831332832
Name:GUIRGUIS, SAMUEL (DO)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:GUIRGUIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40946 US HIGHWAY 19 N STE 101
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5446
Mailing Address - Country:US
Mailing Address - Phone:979-492-7761
Mailing Address - Fax:
Practice Address - Street 1:40946 US HIGHWAY 19 N STE 101
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5446
Practice Address - Country:US
Practice Address - Phone:979-492-7761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH00809782085R0202X
ND139972085R0202X
TXR96242085R0202X
WAOP607314022085R0202X
OH34.0121072085R0202X
LA3221892085R0202X
IN02004513A2085R0202X
FLOS132252085R0202X
IL036.1302102085R0202X
ORDO1888572085R0202X
CODO.00617212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology