MEDICARE: MATTHEW MONIR HANNA

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1447990494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW MONIR HANNA

Provider Business Mailing Address
First Line	:	701 N CLAYTON ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-3165
Country	:	US
Telephone Number	:	302-575-8040
Fax Number	:	302-483-2356

Provider Business Practice Location Address
First Line	:	701 N CLAYTON ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-3165
Country	:	US
Telephone Number	:	302-575-8040
Fax Number	:	302-483-2356

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

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	01/31/2026

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