Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 4771413 | TN |
NPI | 1093761124 |
---|---|
Provider Name | Wahid T Hanna |
First Address | Knoxville, TN 37920-1545 |
Second Address | Knoxville, TN 37920-1545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 22/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12508 | (05) | TN |
B04026 | (02) | TN |