Healthcare Provider Details

I. General information

NPI: 1982229423
Provider Name (Legal Business Name): RACHEL MARIE HANNUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 S CEDAR CREST BLVD STE 210
ALLENTOWN PA
18103-6271
US

IV. Provider business mailing address

2100 MACK BLVD FL 4
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-8506
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberMD496737
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: