Organization
PEDIATRIC HEMATOLOGY CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARWAN DAOUD HANNA M.D. (PRESIDENT)
(605) 322-7595
Entity
Organization
Contact information
Practice address
1000 E 21ST ST, SUITE 3100, SIOUX FALLS, SD 57105-1035
(605) 322-7595
(605) 322-7599
Mailing address
1000 E 21ST ST, SUITE 3100, SIOUX FALLS, SD 57105-1035
(605) 322-7595
(605) 322-7599
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
1562
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3008526
MEDICA GROUP NUMBER
SD
01
—
4997079
BCBS OF SD GROUP NUMBER
SD
Enumeration date
02/07/2007
Last updated
08/22/2020
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