Provider Demographics
NPI:1609067917
Name:HAHN, LINUS SUNGSIK (MD)
Entity type:Individual
Prefix:DR
First Name:LINUS
Middle Name:SUNGSIK
Last Name:HAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LINUS
Other - Middle Name:SUNGSIK
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6 ESSEX CENTER DR STE 304
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2907
Mailing Address - Country:US
Mailing Address - Phone:978-854-6376
Mailing Address - Fax:978-646-2120
Practice Address - Street 1:6 ESSEX CENTER DR STE 304
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2907
Practice Address - Country:US
Practice Address - Phone:978-854-6376
Practice Address - Fax:978-646-2120
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA236055207R00000X
VA0116017126390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110119376AMedicaid