Individual
WILLIAM DOMINIC HANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25990 KELLY RD STE 4, ROSEVILLE, MI 48066-4483
(586) 774-3780
(586) 774-0098
Mailing address
25990 KELLY RD STE 4, ROSEVILLE, MI 48066-4483
(586) 774-3780
(586) 774-0098
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
WH045614
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290501782
BCBSM
MI
05
—
4816147
—
MI
01
—
P00282000
RAILROAD MEDICARE PIN
MI
Enumeration date
04/25/2006
Last updated
08/14/2025
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