Hansen, Sam
Hansen, Sam is an individual health care provider with primary practice located at 3900 St Francis Way Ste 205 , Lafayette IN 47905-4939. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Hansen, Sam can be contacted via phone (765) 428-2500.Contact Information
Primary practice address
3900 St Francis Way Ste 205
Lafayette IN 47905-4939
Phone: (765) 428-2500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 01054645A | Indiana |
Profile Details
| NPI number | 1154397701 |
|---|---|
| LBN Legal business name | Hansen, Sam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 24th, 2006 |
| Last updated | Jun 27th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154397701 | NPPES |
| Indiana | MEDICAID | 200342990 |
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