Individual
PAUL L. HANNAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3787 GRANT ST, GARY, IN 46408-2142
(219) 981-4800
(219) 981-4805
Mailing address
3787 GRANT ST, GARY, IN 46408-2142
(219) 981-4800
(219) 981-4805
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01031585
IN
2084P0804X
Child & Adolescent Psychiatry Physician
01031585
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100213680 A
—
IN
05
—
200473640A
—
IN
Enumeration date
04/14/2007
Last updated
09/02/2021
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