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General NPI Number Information
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NPI Number | 1003976200
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Entity Type | Individual
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Provider Name | PAUL CANNING HANAHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 50 NORMANDY DR STE 5
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City | PAINESVILLE
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State | OH
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Zip | 44077-1600
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Country | US
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Telephone | 440-354-4747
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Fax | 440-354-3530
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Provider Business Mailing Address
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Address Line | 4541 TURNEY RD
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City | MADISON
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State | OH
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Zip | 44057-9773
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Country | US
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Telephone | 440-259-5550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39750
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License Number State | OH
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