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NPI Code Detail

MEDICARE: IBRAHIM HANNA MD

MEDICARE: IBRAHIM HANNA 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
1208600000XSurgery Physician21422WV
2208600000XSurgery Physician0101271318VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D69322OTHERMD LIC

General Provider Information

NPI Number : 1942278791
Entity Type Code : Individual
Provider Name (Legal Business Name) : IBRAHIM HANNA MD
Provider Business Mailing Address
First Line : PO BOX 37174
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-3174
Country : US
Telephone Number : 571-423-5699
Fax Number : 571-423-5698
Provider Business Practice Location Address
First Line : 2501 PARKERS LN
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22306-3209
Country : US
Telephone Number : 703-664-7014
Fax Number : 703-664-7235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 02/22/2021

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Directions to “ IBRAHIM HANNA MD” Practice Location

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