Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 054572 | GA |
N | 2080A0000X | Adolescent Medicine | 054572 | GA |
NPI | 1013978048 |
---|---|
Provider Name | Aaron W Hanna |
First Address | Augusta, GA 30909-1807 |
Second Address | Augusta, GA 30909-1807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 30/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
833380219A | (05) | GA |