Individual
JOHN M HANNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10020 NICHOLAS STREET, SUITE 202, OMAHA, NE 68114-2188
(402) 393-2023
(402) 393-3244
Mailing address
10020 NICHOLAS STREET, SUITE 202, OMAHA, NE 68114-2188
(402) 393-2023
(402) 393-3244
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
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