Individual
DAVID PAUL HANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9501 ROOSEVELT BLVD, SUITE 400, PHILADELPHIA, PA 19114-1025
(215) 969-7510
(215) 969-7513
Mailing address
PO BOX 16335, PHILADELPHIA, PA 19114-0435
(215) 969-7510
(215) 969-7513
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD418571
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1582028
BLUE SHIELD
PA
Enumeration date
05/10/2006
Last updated
03/11/2008
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