Healthcare Provider Details

I. General information

NPI: 1942268438
Provider Name (Legal Business Name): DANKA SAMARDZIC M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/07/2021
Certification Date: 03/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 BILLERICA RD
CHELMSFORD MA
01824-3604
US

IV. Provider business mailing address

228 BILLERICA RD
CHELMSFORD MA
01824-3604
US

V. Phone/Fax

Practice location:
  • Phone: 978-250-6100
  • Fax: 978-250-6002
Mailing address:
  • Phone: 978-250-6100
  • Fax: 978-250-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number220725
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: