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General NPI Number Information
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NPI Number | 1831348176
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Entity Type | Individual
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Provider Name | DR. DOUGLAS HANNEMAN
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Gender | Male
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 320 E NORTH AVE
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City | PITTSBURGH
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State | PA
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Zip | 15212-4756
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Country | US
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Telephone | 412-359-4963
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Fax |
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Provider Business Mailing Address
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Address Line | 351 FISK ST # 2
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City | PITTSBURGH
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State | PA
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Zip | 15201-1750
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MT190079
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License Number State | PA
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