MEDICARE: DR. MICHAEL A. HENNIGAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME133406	FL
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	173573	AK
3	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	00014952	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000081181	OTHER	AL	BCBS OF AL PROVIDER NUMBE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003971839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL A. HENNIGAN M.D.

Provider Business Mailing Address
First Line	:	3 MEDICAL PARK
Second Line	:
City	:	FAIRHOPE
State	:	AL
Zip	:	36532-1804
Country	:	US
Telephone Number	:	251-929-4324
Fax Number	:	251-279-3931

Provider Business Practice Location Address
First Line	:	3 MEDICAL PARK
Second Line	:
City	:	FAIRHOPE
State	:	AL
Zip	:	36532-1804
Country	:	US
Telephone Number	:	251-929-3424
Fax Number	:	251-279-3931

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	03/11/2024

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Directions to “ DR. MICHAEL A. HENNIGAN M.D.” Practice Location

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