Provider Demographics
NPI:1467846006
Name:HANSDORFER, MAREK (MD, MS)
Entity type:Individual
Prefix:DR
First Name:MAREK
Middle Name:
Last Name:HANSDORFER
Suffix:
Gender:
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2287
Mailing Address - Country:US
Mailing Address - Phone:231-935-0800
Mailing Address - Fax:231-935-0808
Practice Address - Street 1:701 W FRONT ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2287
Practice Address - Country:US
Practice Address - Phone:231-935-0800
Practice Address - Fax:231-935-0808
Is Sole Proprietor?:No
Enumeration Date:2015-03-21
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100871502082S0105X
390200000X
MI43015144902082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program