Provider Demographics
NPI:1669496527
Name:HANNA, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
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 2127
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-2127
Mailing Address - Country:US
Mailing Address - Phone:256-236-5631
Mailing Address - Fax:256-236-5637
Practice Address - Street 1:1010 CHRISTINE AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5710
Practice Address - Country:US
Practice Address - Phone:256-236-5631
Practice Address - Fax:256-236-5637
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00008088207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0410294OtherUNITED HEALTHCARE
AL82768Medicare PIN
AL0410294OtherUNITED HEALTHCARE
AL1066920001Medicare NSC