Provider Type Icon

DR. MARK CHARLES HANNIBAL M.D. PH.D. NPI 1548350432


NPI Information

NPI: 1548350432
Provider Name: DR. MARK CHARLES HANNIBAL, M.D., PH.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1500 E MEDICAL CENTER DR
6TH FLOOR MOTT CHILDRENS HOSPITAL
ANN ARBOR, MI
ZIP 48109
Phone: (734) 936-4185
Get Directions

DR. Mark Charles Hannibal, M.D., PH.D. is a pediatrics in Ann Arbor, MI with 30 years of experience. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Mark Charles Hannibal, M.D., PH.D. NPI is 1548350432. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduation Year:1994

The provider's business location address is:

1500 E MEDICAL CENTER DR
6TH FLOOR MOTT CHILDRENS HOSPITAL
ANN ARBOR, MI
ZIP 48109-259
Phone: (734) 936-4185

The NPI 1548350432 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/13/2006 and was last updated on 9/13/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207SG0201XMedical GeneticsClinical Genetics (M.D.)MD00037850WASHINGTONNo
2207SG0201XMedical GeneticsClinical Genetics (M.D.)4301099786MICHIGANNo
3208000000XPediatrics4301099786MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13199OTHERINTERNAL ID-MOTOR VEHICLE ID
2H04982MEDICARE UPIN
3AB11550MEDICARE ID-TYPE UNSPECIFIED
48246647MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.