Individual
STEPHAN D HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1907 ANN ST, PARKERSBURG, WV 26101-2504
(304) 424-4205
(304) 424-4485
Mailing address
RR 1 BOX 256, WASHINGTON, WV 26181-9708
(304) 863-3373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13524
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000034367
BLUE CROSS/BLUE SHIELD
—
05
—
0056732000
—
WV
05
—
0541186
—
OH
01
—
080094477
RAILROAD MEDICARE
—
Enumeration date
05/05/2006
Last updated
07/01/2010
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