Provider Demographics
NPI:1376790618
Name:HANSMANN, GEORG (MD)
Entity Type:Individual
Prefix:
First Name:GEORG
Middle Name:
Last Name:HANSMANN
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:C/O ALEX VON GIESE
Mailing Address - Street 2:433 CAMBRIDGE STREET
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141
Mailing Address - Country:US
Mailing Address - Phone:617-355-8539
Mailing Address - Fax:
Practice Address - Street 1:DEPT. OF CARDIOLOGY, CHILDREN'S HOSPITAL
Practice Address - Street 2:300 LONGWOOD AVE.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-8539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237972208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics