Provider Demographics
NPI:1710090972
Name:BUJAK, HANNAH MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:MARIE
Last Name:BUJAK
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 1:4976 ALPHA LN
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-5470
Mailing Address - Country:US
Mailing Address - Phone:423-497-5355
Mailing Address - Fax:423-308-0281
Practice Address - Street 1:9309 APISON PIKE
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4340
Practice Address - Country:US
Practice Address - Phone:423-551-3562
Practice Address - Fax:423-551-3563
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51875207Q00000X, 207Q00000X
WAMD60178935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0269680OtherL&I
NY02796330Medicaid
WA0269680OtherL&I
I67671Medicare UPIN
NYRB1819Medicare PIN