Provider Demographics
NPI:1790726339
Name:HANNA, SUZANNE MISSAK (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MISSAK
Last Name:HANNA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6115 FLAMINGO DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-5109
Mailing Address - Country:US
Mailing Address - Phone:540-982-2463
Mailing Address - Fax:540-224-1958
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-224-1958
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
VA0101235930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine