MEDICARE: DR. WENDY JEANNE HANAFEE 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	2085R0202X	Diagnostic Radiology Physician	01048647A	IN
2	2085R0202X	Diagnostic Radiology Physician	MD460368	PA
3	2085R0202X	Diagnostic Radiology Physician	ME123549	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00100329	OTHER	IN	RAILROAD MEDICARE
5	300084640	OTHER	IN	RAILROAD MEDICARE
6	300127680	OTHER	IN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
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	:	1568459691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY JEANNE HANAFEE M.D.

Provider Business Mailing Address
First Line	:	2527 CRANBERRY HIGHWAY
Second Line	:	AFFILIATED PROFESSIONAL SERVICES
City	:	WAREHAM
State	:	MA
Zip	:	02571
Country	:	US
Telephone Number	:	508-295-7271
Fax Number	:	508-273-1241

Provider Business Practice Location Address
First Line	:	1590 GULF BLVD # CONDO503
Second Line	:
City	:	CLEARWATER BEACH
State	:	FL
Zip	:	33767-2938
Country	:	US
Telephone Number	:	610-770-1606
Fax Number	:

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	11/19/2018

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