Samuel G Hawk, DO
General Practice in Ham Lake, MN. Individual provider (NPI-1).
NPI number1366763567
StatusActive
Last updated in NPPESJul 8, 2021
Details
- NPI
- 1366763567
- Entity type
- Individual (NPI-1)
- Name
- Samuel G Hawk
- Credential
- DO
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 22, 2010
- Certification date
- Jul 8, 2021
- Last updated
- Jul 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | DOS-1424 | HI | Yes |
Practice location
14326 Rochester St NeHam Lake, MN 55304-6266
Phone 612-486-2226
Mailing address
14326 Rochester St NeHam Lake, MN 55304-6266
Phone 612-486-2226
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