MEDICARE: HANNAH PHILLIPS PEARCE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101054281	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	542013472	OTHER	VA	TAX ID #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	181058	OTHER	VA	ANTHEM HEALTHKEEPERS
4	31710300001	OTHER	VA	SOUTHERN HEALTH
5	181058	OTHER	VA	ANTHEM BC/BS

General Provider Information

NPI Number	:	1205839008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH PHILLIPS PEARCE M.D.

Provider Business Mailing Address
First Line	:	3350 BERKMAR DRIVE
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901
Country	:	US
Telephone Number	:	434-923-4651
Fax Number	:	434-964-3636

Provider Business Practice Location Address
First Line	:	3350 BERKMAR DRIVE
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901
Country	:	US
Telephone Number	:	434-923-4651
Fax Number	:	434-964-3636

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	06/28/2013

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