Provider Demographics
NPI:1639172588
Name:HANUS, MICHAEL C (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:HANUS
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 1:8625 COLLIER BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-3550
Mailing Address - Country:US
Mailing Address - Phone:239-429-0100
Mailing Address - Fax:239-421-8209
Practice Address - Street 1:8625 COLLIER BLVD STE 102
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3550
Practice Address - Country:US
Practice Address - Phone:239-429-0100
Practice Address - Fax:239-421-8209
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME822152085R0001X
FLME00822152085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101584OtherWELLCARE
FL2072605-001OtherCIGNA PROVIDER NUMBER
FL592485899OtherMETCARE VENDOR ID #
FL00792OtherUNV. HLTHCR. PROVIDER #
FL24-00216OtherUTD. HLTHCR. PROVIDER #
FL261474000Medicaid
FL278526OtherAVMED PROVIDER NUMBER
FL85448OtherOP. ENG. LOC. 825 PROV. #
FLME82215OtherMETCARE PROVIDER ID #
FL7004248OtherAETNA PROVIDER NUMBER
FL8329OtherAVMED PIN NUMBER
FL207227OtherAMERIGROUP GROUP #
FL278526OtherAVMED PROVIDER NUMBER
FLH36900Medicare UPIN