Provider Demographics
NPI:1104849231
Name:HANNA, GAMIL S (MD)
Entity Type:Individual
Prefix:
First Name:GAMIL
Middle Name:S
Last Name:HANNA
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 1:409 ROUTE 70 EAST
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2413
Mailing Address - Country:US
Mailing Address - Phone:856-429-1519
Mailing Address - Fax:856-427-0250
Practice Address - Street 1:409 ROUTE 70 EAST
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2413
Practice Address - Country:US
Practice Address - Phone:856-429-1519
Practice Address - Fax:856-427-0250
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25MA06677600207RH0003X
PAMD429107207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH58994Medicare UPIN