Provider Demographics
NPI:1942268438
Name:SAMARDZIC, DANKA (MD)
Entity Type:Individual
Prefix:
First Name:DANKA
Middle Name:
Last Name:SAMARDZIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 BILLERICA RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3604
Mailing Address - Country:US
Mailing Address - Phone:978-250-6100
Mailing Address - Fax:978-250-6002
Practice Address - Street 1:228 BILLERICA RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3604
Practice Address - Country:US
Practice Address - Phone:978-250-6100
Practice Address - Fax:978-250-6002
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220725207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
J29662OtherBXBS
MAI09860Medicare UPIN
MAA37113Medicare PIN