Provider Demographics
NPI:1568435451
Name:MIEDEL, HANNAH E (MD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:E
Last Name:MIEDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 N GRANT ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-1166
Mailing Address - Country:US
Mailing Address - Phone:330-674-8444
Mailing Address - Fax:330-674-2528
Practice Address - Street 1:931 WOOSTER RD
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-1536
Practice Address - Country:US
Practice Address - Phone:330-674-8444
Practice Address - Fax:330-674-2528
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35089525207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2754523Medicaid
OH2754523Medicaid