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NPI 1265437883

NPI 1265437883 : STEVEN J HANAS MD : DE WITT, IA

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General NPI Number Information
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    NPI Number           |    1265437883
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN J HANAS MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/20/2005
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    Last Update Date     |    07/09/2007
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Provider Practice Location Address
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    Address Line         |    1008 11TH ST 
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    City                 |    DE WITT
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    State                |    IA
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    Zip                  |    52742-1210
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    Country              |    US
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    Telephone            |    563-659-9137
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    Fax                  |    563-659-9869
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Provider Business Mailing Address
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    Address Line         |    865 LINCOLN RD STE L10
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    City                 |    BETTENDORF
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    State                |    IA
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    Zip                  |    52722-4159
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    Country              |    US
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    Telephone            |    563-355-9191
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    Fax                  |    563-355-3419
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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       |    21194
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    License Number State |    IA
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