Individual
LAURENCE GERALD HANELIN
Active
Individual
LAURENCE GERALD HANELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
27584
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
27584
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005472
GROUP MEDICAID ID
AZ
01
—
1609846922
PHYSICIAN INDIVIDUAL NPI
AZ
01
—
1841261989
GROUP NPI
AZ
01
—
300102513
MEDICARE RAILROAD
AZ
05
—
473835
—
AZ
01
—
CS7943
GROUP MEDICARE RAILROAD ID & PTAN
AZ
01
—
ZWCBBM
GROUP MEDICARE ID
AZ
Enumeration date
01/26/2006
Last updated
01/30/2013
Update your record
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