Individual
MIRANDA FERN HANNAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
144 N RAVENEL ST, FLORENCE, SC 29506-2641
(843) 777-2800
Mailing address
144 N RAVENEL ST, FLORENCE, SC 29506-2641
(843) 777-2800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MMD.87779.LL
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2022
Last updated
07/26/2023
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