Provider Demographics
NPI:1942369632
Name:HAMDAN, SAMIR (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:
Last Name:HAMDAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 PARK AVENUE
Mailing Address - Street 2:SUITE 901
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609
Mailing Address - Country:US
Mailing Address - Phone:508-793-0719
Mailing Address - Fax:508-793-0719
Practice Address - Street 1:255 PARK AVENUE
Practice Address - Street 2:SUITE 901
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609
Practice Address - Country:US
Practice Address - Phone:508-793-0719
Practice Address - Fax:508-793-0719
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U62672Medicare UPIN
MAY45063Medicare ID - Type Unspecified