Individual
SAMUEL L HISSONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5423 PENINSULA DR NW, CANTON, OH 44718-1633
(330) 904-8716
Mailing address
5423 PENINSULA DR NW, CANTON, OH 44718-1633
(330) 904-8716
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35 030121
OH
2085U0001X
Diagnostic Ultrasound Physician
35030121
OH
Other
Enumeration date
11/02/2005
Last updated
10/18/2023
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