MEDICARE: WILLIAM HANNA 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	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	232920	MA
2	2080P0203X	Pediatric Critical Care Medicine Physician	35.097530	OH

General Provider Information

NPI Number	:	1134328537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM HANNA M.D.

Provider Business Mailing Address
First Line	:	4326 BAINTREE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-3931
Country	:	US
Telephone Number	:	304-617-5206
Fax Number	:

Provider Business Practice Location Address
First Line	:	4326 BAINTREE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-3931
Country	:	US
Telephone Number	:	304-617-5206
Fax Number	:

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

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	05/23/2016

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