Individual
AMANDA PHAN HANAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3186 S MARYLAND PKWY, LAS VEGAS, NV 89109-2317
(702) 697-0082
Mailing address
3186 S MARYLAND PKWY, LAS VEGAS, NV 89109-2317
(702) 697-0082
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.146509
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036.146509
—
IL
Enumeration date
04/04/2015
Last updated
10/25/2024
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