Individual
PETER HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 EAST MOUNTAIN BLVD, WILKES BARRE, PA 18711-3478
(570) 808-7856
(570) 808-1069
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS007131L
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
12826434-1204
UT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
195753
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
OS-007131-L
PA
208M00000X
Hospitalist Physician
OS007131L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013918390006
—
PA
01
—
1689
GEISINGER
PA
01
—
232809429008
TRICARE
PA
01
—
50073483
KEYSTONE HEALTH PLAN
PA
01
—
HA425022
HIGHMARK BLUE SHIELD
PA
Enumeration date
05/26/2006
Last updated
06/27/2023
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