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Individual
MARIYA M HANNEMAN
Active
Individual
MARIYA M HANNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02169
NC
363AM0700X
Medical Physician Assistant
0010-02169
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265764112
—
NC
05
—
1322PA
—
SC
Enumeration date
02/03/2010
Last updated
10/16/2025
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