Provider Demographics
NPI:1437311768
Name:HANNA, SHERRY (MD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 BAY POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-5155
Mailing Address - Country:US
Mailing Address - Phone:310-308-4482
Mailing Address - Fax:
Practice Address - Street 1:699 BAY POINTE DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-5155
Practice Address - Country:US
Practice Address - Phone:310-308-4482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNOT YET ISSUED207P00000X
MINOT YET ISSUED207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine