Individual
MICHAEL DALTON HANOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5126 HOSPITAL DR NE, COVINGTON, GA 30014-2566
(770) 385-4426
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
001560
GA
208VP0000X
Pain Medicine Physician
Primary
061846
GA
208VP0014X
Interventional Pain Medicine Physician
061846
GA
Other
Enumeration date
01/27/2008
Last updated
08/15/2016
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