Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 31140 | NC |
NPI | 1417043860 |
---|---|
Provider Name | Dr. Michael W Hanson |
First Address | Durham, NC 27704-2121 |
Second Address | Durham, NC 27704-2121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8939089 | (05) | NC |
B96453 | (02) |