Dr. Mark Charles Hannibal
Pediatrician Clinical Genetics (M.D.)
1500 E Medical Center Dr 6th Floor Mott Childrens Hospital
Ann Arbor
, Michigan 48109-4259
Dr. Mark Charles Hannibal
Pediatrician Clinical Genetics (M.D.)
1500 E Medical Center Dr 6th Floor Mott Childrens Hospital
Ann Arbor
, Michigan 48109-4259
(734) 936-2047
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About
Features
Specialties
- Clinical Genetics (M.D.)
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Mark Charles Hannibal
- 3621 S State St 700 Kms Place
- Ann Arbor, MI
- Zip : 48108
- Phone : (734) 936-2047
Second Address
- Dr. Mark Charles Hannibal
- 1500 E Medical Center Dr 6th Floor Mott Childrens Hospital
- Ann Arbor, MI
- Zip : 48109-4259
- Phone : (734) 936-4185
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Is Dr. Mark Charles Hannibal a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207SG0201X | Clinical Genetics (M.D.) | 4301099786 | MI |
| N | 207SG0201X | Clinical Genetics (M.D.) | MD00037850 | WA |
| Y | 208000000X | Pediatrician | 4301099786 | MI |
National Provider Identifier
| NPI | 1548350432 |
|---|---|
| Provider Name | Dr. Mark Charles Hannibal |
| First Address | Ann Arbor, MI 48108 |
| Second Address | Ann Arbor, MI 48109-4259 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/10/2006 |
| Last Update Date | 13/09/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3199 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
| 8246647 | (05) | WA |
| H04982 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.