Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 35089697 | OH |
NPI | 1225001183 |
---|---|
Provider Name | Dr. David Hannallah |
First Address | Columbus, OH 43213-4441 |
Second Address | Columbus, OH 43213-4441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 05/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000520345 | ANTHEM (01) | OH |
101224851 | (05) | PA |
7721946 | AETNA (01) | OH |
I27461 | (02) | PA |