Provider Demographics
NPI:1043278336
Name:HANGGI, MATTHEW C (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:HANGGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:123 FOX RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3369
Mailing Address - Country:US
Mailing Address - Phone:865-690-9467
Mailing Address - Fax:865-637-5057
Practice Address - Street 1:123 FOX RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3369
Practice Address - Country:US
Practice Address - Phone:865-690-9467
Practice Address - Fax:865-637-5057
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38448207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3896989Medicaid
TN7807328OtherAETNA
TN4084413OtherBLUE CROSS
TN4084413OtherBLUE CROSS
TNH56592Medicare UPIN