# MARK R HANABURY JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134121338
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 0101031266 | VA | — |
| 207Y00000X | Otolaryngology Physician | 0101031266 | VA | Yes |

## Other

- **Enumeration date:** 06/01/2005
- **Last updated:** 12/15/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 010083621 | — | VA |
| 01 | — | 1000135 | UNITED HEALTH | — |
| 05 | — | 1134121338 | — | VA |
| 01 | — | 143175 | ANTHEM | — |
| 01 | — | 243144 | SOUTHERN HEALTH | — |
| 01 | — | 4243474 | AETNA | — |
| 01 | — | TN0101 | JOHN DEERE | — |