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NPI Code Detail

MEDICARE: MICHAEL W HENNIGAN MD

MEDICARE: MICHAEL W HENNIGAN MD
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
1208100000XPhysical Medicine & Rehabilitation PhysicianME0064533FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427040906
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL W HENNIGAN MD
Provider Business Mailing Address
First Line : 1847 FLORIDA AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4640
Country : US
Telephone Number : 850-914-8660
Fax Number : 850-914-6036
Provider Business Practice Location Address
First Line : 1847 FLORIDA AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4640
Country : US
Telephone Number : 850-914-8660
Fax Number : 850-914-6036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 03/21/2017

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