NPI Code Detail JSON Logo

1104359637 NPI number — PETER HANNA MD

NPI Number: 1104359637
Health Care Provider/Practitioner: PETER HANNA MD

Information about “1104359637” NPI (PETER HANNA MD) exists in 1104359637 in HTML format HTML  |  1104359637 in plain Text format TXT  |  1104359637 in PDF (Portable Document Format) PDF  |  1104359637 in an XML format XML  formats.

NPI Number : 1104359637 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104359637",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HANNA",
    "FirstName": "PETER",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "110 S PACA ST FL 7",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BALTIMORE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21201-1642",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "410-328-7877",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4755 OGLETOWN STANTON RD STE 1070",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEWARK",
    "PracticeLocationAddressStateName": "DE",
    "PracticeLocationAddressPostalCode": "19718-1642",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "302-733-1663",
    "PracticeLocationAddressFaxNumber": "302-733-4533",
    "EnumerationDate": "04/11/2017",
    "LastUpdateDate": "08/05/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "C1-0027017",
          "LicenseNumberStateCode": "DE",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "D0100180",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RC0000X",
          "TaxonomyName": "Cardiovascular Disease Physician",
          "LicenseNumber": "D0100180",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RC0000X",
          "TaxonomyName": "Cardiovascular Disease Physician",
          "LicenseNumber": "C1-0027017",
          "LicenseNumberStateCode": "DE",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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