MEDICARE: DR. HAZEL E KANU MD

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	208000000X	Pediatrics Physician	35065969	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376529404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAZEL E KANU MD

Provider Business Mailing Address
First Line	:	3101 BURNET AVENUE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3098
Country	:	US
Telephone Number	:	513-357-7289
Fax Number	:	513-352-3137

Provider Business Practice Location Address
First Line	:	3301 BEEKMAN ST
Second Line	:	MILLVALE HEALTH CENTER
City	:	CINCINNATI
State	:	OH
Zip	:	45225-1205
Country	:	US
Telephone Number	:	513-352-3192
Fax Number	:	513-352-3137

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

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	02/25/2013

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Directions to “ DR. HAZEL E KANU MD” Practice Location

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