Provider Demographics
NPI:1568459691
Name:HANAFEE, WENDY JEANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:JEANNE
Last Name:HANAFEE
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 1:2527 CRANBERRY HIGHWAY
Mailing Address - Street 2:AFFILIATED PROFESSIONAL SERVICES
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571
Mailing Address - Country:US
Mailing Address - Phone:508-295-7271
Mailing Address - Fax:508-273-1241
Practice Address - Street 1:1590 GULF BLVD # CONDO503
Practice Address - Street 2:
Practice Address - City:CLEARWATER BEACH
Practice Address - State:FL
Practice Address - Zip Code:33767-2938
Practice Address - Country:US
Practice Address - Phone:610-770-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048647A2085R0202X
PAMD4603682085R0202X
FLME1235492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00100329OtherRAILROAD MEDICARE
KY64881378Medicaid
IN200163510Medicaid
PA103301691Medicaid
IN300084640OtherRAILROAD MEDICARE
IN300127680OtherRAILROAD MEDICARE
IN300084640OtherRAILROAD MEDICARE
IN200163510Medicaid
INP00100329OtherRAILROAD MEDICARE
IL$$$$$$$$$Medicaid
IN214790FMedicare PIN
IN352056384OtherTIN
INP00100329OtherRAILROAD MEDICARE