Basic Information
Provider Information
NPI: 1659418010
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HANSON
FirstName: SARAH
MiddleName: JEAN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 15 HOSPITAL DR
Address2:  
City: YORK
State: ME
PostalCode: 039091011
CountryCode: US
TelephoneNumber: 2073512478
FaxNumber: 2073512216
Practice Location
Address1: 15 HOSPITAL DR
Address2:  
City: YORK
State: ME
PostalCode: 039091011
CountryCode: US
TelephoneNumber: 2073513455
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/01/2007
LastUpdateDate: 09/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VX0000XMD22892MEN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
207V00000XP21380MDY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
MD2289201MESTATE MEDICAL LICENSEOTHER


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