Individual
DR. SHADI HAMDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 SHORE DR, MARINETTE, WI 54143-4242
(715) 735-4200
Mailing address
3100 SHORE DR, MARINETTE, WI 54143-4242
(715) 735-4200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
60658
WI
207RH0003X
Hematology & Oncology Physician
Primary
60658
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12518401
CAQH/ REF NUMBER FOR BLUE CROSS BLUE SHILED
WI
Enumeration date
08/13/2007
Last updated
10/21/2015
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