Individual
MR. MICHAEL DONOVAN MCHANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPA-C, LSA,CST/CFA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
SA00046
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3126400
AETNA PROVIDER ID
TX
01
—
8N3529
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/19/2006
Last updated
02/23/2022
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