Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Suhas Joe Samuel, MD

Individual provider Sports Medicine (Family Medicine) Physician · NPI 1356632962

Dr. Suhas Joe Samuel, MD is a Family Practice in Ellenwood, Georgia. Qualified in 2009, 17 years ago. Practices with Northside Urgent Care Holding LLC, a 80-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
17
Licensed in
GA
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2720 Quiktrip Way
Ellenwood, GA 30294-3504
Phone: (470) 582-5698
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 072465 (GA)

Record details

NPI number1356632962
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 29, 2011
Last updated in NPPESJanuary 19, 2023
Certification dateJanuary 13, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Northside Urgent Care Holding Llc — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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