Hanabury, Mark R

Hanabury, Mark R is an individual health care provider with primary practice located at 1802 Braeburn Dr , Salem VA 24153-7357. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Hanabury, Mark R can be contacted via phone (540) 772-3433.

Contact Information

Primary practice address
1802 Braeburn Dr Salem VA 24153-7357
Phone: (540) 772-3433
Fax: (540) 772-5994
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101031266 Virginia
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 0101031266 Virginia

Profile Details

NPI number 1134121338
LBN Legal business name Hanabury, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Dec 15th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134121338 NPPES
Other 4243474 AETNA
Other TN0101 AETNA
Other 143175 AETNA
MEDICAID 1134121338 AETNA
MEDICAID 010083621 AETNA
Other 1000135 AETNA
Other 243144 AETNA

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