| Doctor Name: | BRUCE MICHAEL SAMSON |
| NPI Number: | 1962708503 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 023083 |
| Business Practice Address: | 13234 Fawn Dr Osakis, MN - 563604858 |
| Business Phone Number: | 9522409298 |
| Business Fax Number: | 9529551970 |
| Mailing Address: | 13234 Fawn Dr, OSAKIS |
| State: | MN |
| Postal Code: | 563604858 |
| Phone Number: | 9522409298 |
| Fax Number: | 9529551970 |
| NPI Enumeration Date: | 01/30/2011 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 023083 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |