Provider Demographics
NPI:1609817121
Name:CAUGHRON, SAMUEL D (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:D
Last Name:CAUGHRON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:901 PRESTON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4491
Mailing Address - Country:US
Mailing Address - Phone:434-977-3140
Mailing Address - Fax:434-977-4984
Practice Address - Street 1:901 PRESTON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4491
Practice Address - Country:US
Practice Address - Phone:434-977-3140
Practice Address - Fax:434-977-4984
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101029225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB07215Medicare UPIN