MEDICARE: DR. CINDY L HANAWALT MD, PHD, MS

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	207Q00000X	Family Medicine Physician	34383	IA
2	2083X0100X	Occupational Medicine Physician	0101281318	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15689	OTHER	IA	WELLMARK BCBS OF IOWA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316930779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CINDY L HANAWALT MD, PHD, MS

Provider Business Mailing Address
First Line	:	125 NATIONWIDE DR
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24502-4272
Country	:	US
Telephone Number	:	434-200-6933
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 NATIONWIDE DR
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24502-4272
Country	:	US
Telephone Number	:	434-200-6933
Fax Number	:	434-200-6933

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	06/28/2024

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