Provider Demographics
NPI:1679137756
Name:HAMNVAG, HANS-MAGNE HANSEN (MD)
Entity Type:Individual
Prefix:MR
First Name:HANS-MAGNE
Middle Name:HANSEN
Last Name:HAMNVAG
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:ROKIETNICKA 5E/628
Mailing Address - Street 2:
Mailing Address - City:POZNAN
Mailing Address - State:WIELKOPOLSKIE
Mailing Address - Zip Code:60806
Mailing Address - Country:PL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2460 S 1ST AVENUE LOYOLA UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-327-2689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.075297207ZP0102X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program