Provider Demographics
NPI:1508960972
Name:HANN, LOUISA J (MD)
Entity Type:Individual
Prefix:
First Name:LOUISA
Middle Name:J
Last Name:HANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 79777
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0777
Mailing Address - Country:US
Mailing Address - Phone:434-654-7794
Mailing Address - Fax:434-654-4555
Practice Address - Street 1:310 OLD IVY WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903
Practice Address - Country:US
Practice Address - Phone:434-654-4550
Practice Address - Fax:434-654-4555
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101239562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H99991Medicare UPIN
VAP01504925Medicare PIN
VA020694M54Medicare PIN