Provider Demographics
NPI:1508161225
Name:SAM HEMANS MD LLC
Entity Type:Organization
Organization Name:SAM HEMANS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANKSON HEMANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-224-6801
Mailing Address - Street 1:20404 POWELL FARM PL
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-2122
Mailing Address - Country:US
Mailing Address - Phone:216-224-6801
Mailing Address - Fax:240-342-2094
Practice Address - Street 1:12200 ANNAPOLIS RD
Practice Address - Street 2:SUITE 123
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9182
Practice Address - Country:US
Practice Address - Phone:301-552-9495
Practice Address - Fax:301-552-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062601207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty