Individual
DR. STEPHEN HANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10018 HARBOUR PINES CT, INDIANAPOLIS, IN 46256-9335
(317) 430-3975
Mailing address
10018 HARBOUR PINES CT, INDIANAPOLIS, IN 46256-9335
(317) 430-3975
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01033930A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100384110
—
IN
01
—
930127220
MEDICARE RR
IN
Enumeration date
06/16/2005
Last updated
04/05/2010
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