Provider Demographics
NPI:1992718514
Name:HAMDANI, S T (MD)
Entity type:Individual
Prefix:
First Name:S
Middle Name:T
Last Name:HAMDANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SYED UZAIR
Other - Middle Name:TANVEER
Other - Last Name:HAMDANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4841 MONROE ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4385
Mailing Address - Country:US
Mailing Address - Phone:419-471-1350
Mailing Address - Fax:
Practice Address - Street 1:4841 MONROE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4385
Practice Address - Country:US
Practice Address - Phone:419-471-1350
Practice Address - Fax:419-741-1690
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD 29229207R00000X
OH35126387207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCI63914Medicare UPIN