Provider Demographics
NPI:1366466542
Name:HANNA, NADER N (MD)
Entity Type:Individual
Prefix:DR
First Name:NADER
Middle Name:N
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:PO BOX 64226
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4742
Mailing Address - Country:US
Mailing Address - Phone:410-328-5300
Mailing Address - Fax:410-328-2109
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5300
Practice Address - Fax:410-328-2109
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062164208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000035763Medicaid
MD64308501OtherBLUE SHIELD
MD90359OtherGEISINGER
MD0098OtherCAREFIRST REGIONAL
MD2127108OtherMDIPA
MD1767113OtherUNITED HLTHCARE NATIONAL
MD1703368OtherUNITED HLTHCARE
MD245547OtherKAISER
MD0098OtherCAREFIRST REGIONAL
MD1703368OtherUNITED HLTHCARE
MDK441Medicare ID - Type Unspecified