Individual
DR. MICHAEL HANNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3215 WESTPORT GREEN PL, LOUISVILLE, KY 40241-3135
(502) 412-1112
(502) 357-0606
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5733
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21500
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000596338
ANTHEM
KY
05
—
64215007
—
KY
Enumeration date
07/26/2006
Last updated
12/04/2020
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