Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | MD.201087 | LA |
Y | 207RI0011X | Interventional Cardiology | MD.201087 | LA |
NPI | 1124215173 |
---|---|
Provider Name | Elias B Hanna |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70808-4370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2007 |
Last Update Date | 10/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1035602 | (05) | LA |