Provider Demographics
NPI:1447561204
Name:HANKA, SAMSON H (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMSON
Middle Name:H
Last Name:HANKA
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:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:700-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:65 CANAL ST
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527-3266
Practice Address - Country:US
Practice Address - Phone:508-865-9960
Practice Address - Fax:508-865-3399
Is Sole Proprietor?:No
Enumeration Date:2010-06-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine