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General NPI Number Information
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NPI Number | 1467470054
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Entity Type | Individual
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Provider Name | STEPHEN E HANNAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 7335 GLADIOLUS DR
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City | FORT MYERS
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State | FL
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Zip | 33908-5101
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Country | US
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Telephone | 239-985-1925
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Fax | 239-321-6044
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME0046939
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License Number State | FL
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