Provider Demographics
NPI:1003470204
Name:HAMDAN, AHMAD (MD)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:HAMDAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6630
Mailing Address - Country:US
Mailing Address - Phone:207-973-4377
Mailing Address - Fax:207-973-5810
Practice Address - Street 1:417 STATE ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6630
Practice Address - Country:US
Practice Address - Phone:207-973-4377
Practice Address - Fax:207-973-5810
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2025-04-08
Deactivation Date:2019-12-04
Deactivation Code:
Reactivation Date:2019-12-10
Provider Licenses
StateLicense IDTaxonomies
ME28086207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease