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Individual

KEVIN HANNAWA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5333 MCAULEY DR, SUITE 2111, YPSILANTI, MI 48197-1014
(734) 712-5001
Mailing address
3264N EVERGREEN NEDR, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301092277
MI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4301092277
MI

Other

Enumeration date
06/07/2008
Last updated
09/08/2015
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