Individual
DR. MARK CHARLES HANNIBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
4301099786
MI
207SG0201X
Clinical Genetics (M.D.) Physician
MD00037850
WA
208000000X
Pediatrics Physician
Primary
4301099786
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3199
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8246647
—
WA
Enumeration date
10/13/2006
Last updated
09/13/2012
Update your record
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