# DR. MICHAEL RAYMOND HANLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1912092958
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401006683 | VA | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 02/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 187470 | ANTHEM | VA |
| 01 | — | 812840 | UNITED CONCORDIA NFS | VA |
| 05 | — | 9179583 | — | VA |