Provider Demographics
NPI:1447656517
Name:HANSCOM, DONALD RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RICHARD
Last Name:HANSCOM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SPRING ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-4006
Mailing Address - Country:US
Mailing Address - Phone:843-987-0207
Mailing Address - Fax:
Practice Address - Street 1:20 SPRING ISLAND DR
Practice Address - Street 2:
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909-4006
Practice Address - Country:US
Practice Address - Phone:843-987-0207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20757207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology