Provider Demographics
NPI:1336373430
Name:HANNAWAY, CHRISTINE DANIELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:DANIELLE
Last Name:HANNAWAY
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 1:100 RAWLINS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-9999
Mailing Address - Country:US
Mailing Address - Phone:302-628-4270
Mailing Address - Fax:
Practice Address - Street 1:100 RAWLINS DRIVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-9999
Practice Address - Country:US
Practice Address - Phone:302-628-4270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101229793208600000X
DEC10009853208600000X
MDD0069715208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC624316OtherMEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC - MEDICARE GOUP
DCB776OtherMEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC - BCBS DC GROUP
MDKR10MEOtherMEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC - BCBS MD GROUP
MD1821030156OtherMEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC - GENERAL SURGERY NPI
MD1851473722OtherMEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC - GROUP NPI
MD222101209OtherMEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC - MEDICAID GROUP
VA7303882Medicaid
VAH55016Medicare UPIN
VA7303882Medicaid
VA009017EEEMedicare PIN