Individual
JOHN M HANNAM
Active
Individual
JOHN M HANNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
17640
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00748
BC/BS INDIVIDUAL
NE
01
—
01907
BC/BS GROUP
NE
01
—
05-00003
SHARE ADVANTAGE - BERGAN
NE
01
—
05-00230
SHARE ADVANTAGE LAKESIDE
NE
01
—
0931584
IOWA MEDICAID INDIVIDUAL
IA
01
—
130005313
RR MEDICARE INDIVIDUAL
NE
01
—
470542490
TRICARE GROUP
NE
05
—
47054249012
—
NE
01
—
656
MIDLANDS CHOICE
NE
Enumeration date
07/27/2006
Last updated
10/13/2015
Update your record
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