DR. SAMUEL DAVID MALDONADO MD PHD NPI 1972130912

NPI Information

  • NPI: 1972130912
  • Provider Name: DR. SAMUEL DAVID MALDONADO, MD, PHD
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 55 FRUIT STREET, BUL-1-130
    BOSTON, MA
    ZIP 02114
  • Phone: (617) 726-3906

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NPI Details

DR. Samuel David Maldonado, MD, PHD is a student in an organized health care education training program in Boston, MA with 6 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Samuel David Maldonado, MD, PHD NPI is 1972130912. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: RUTGERS NEW JERSEY MEDICAL SCHOOL
Graduation Year:2020

The provider's business location address is:

55 FRUIT STREET, BUL-1-130
BOSTON, MA
ZIP 02114
Phone: (617) 726-3906
Fax: (617) 643-4237

The NPI 1972130912 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/26/2020 and was last updated on 2/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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