Individual
MARVIN J HANKA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15507
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000066086
ANTHEM
KY
05
—
64155070
—
KY
Enumeration date
06/24/2005
Last updated
07/08/2007
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