Provider Demographics
NPI:1972574838
Name:TONEY, SAMUEL E (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:E
Last Name:TONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 WILLIAMS CIR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-5975
Mailing Address - Country:US
Mailing Address - Phone:317-569-0380
Mailing Address - Fax:
Practice Address - Street 1:119 S WASHINGTON ST
Practice Address - Street 2:AMBUCARE CLINIC
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3805
Practice Address - Country:US
Practice Address - Phone:765-664-0511
Practice Address - Fax:765-668-2786
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035640A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC24799Medicare UPIN
IN296210AMedicare ID - Type Unspecified