PEDIATRIC HEMATOLOGY CLINIC LTD (NPI# 1003956343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003956343 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC HEMATOLOGY CLINIC LTD |
| Practice Address |
1000 E 21st St Suite 3100 Sioux Falls SD 57105-1035 |
| Practice Telephone | 6053227595 |
| Practice Fax Number | 6053227599 |
| Mailing Telephone | 6053227595 |
| Mailing Fax Number | 6053227599 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MARWAN DAOUD HANNA (PRESIDENT) |
| Authorized Official Telephone | 6053227595 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
1562 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | BCBS OF SD GROUP NUMBER | 4997079 | 01 |
| SD | MEDICA GROUP NUMBER | 3008526 | 01 |
| Street Address |
1000 E 21ST ST SUITE 3100 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821066184 | Samir Zaki Abu-ghazaleh | Obstetrics & Gynecology | 1000 E 21st St, Suite 3000, Sioux Falls, SD 57105-1035 | 2006-03-10 |
| 1144488537 | Avera Mckennan | Pediatrics | 1000 E 21st St, Ste 3100, Sioux Falls, SD 57105-1035 | 2008-06-02 |
| 1548396054 | Luis Alexander Rojas-espaillat | Obstetrics & Gynecology | 1000 E 21st St, Ste. 3000, Sioux Falls, SD 57105-1035 | 2007-02-26 |
| 1952436099 | Pediatric Hematology Oncology Pharmacy Ltc | Pharmacy | 1000 E 21st St, Suite 3100, Sioux Falls, SD 57105-1035 | 2007-02-22 |
| 1669544763 | Obstetrics and Gynecology and Gynecologic Oncology PC | Obstetrics & Gynecology | 1000 E 21st St, Suite 3000, Sioux Falls, SD 57105-1035 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447694617 | Brianna Murphy | Pediatrics | 1600 W 22nd St, Sioux Falls, SD 57105-1521 | 2013-04-18 |
| 1144488537 | Avera Mckennan | Pediatrics | 1000 E 21st St, Ste 3100, Sioux Falls, SD 57105-1035 | 2008-06-02 |
| 1043429087 | Kayelyn J. Wagner | Pediatrics | 1600 W 22nd St, Sioux Falls, SD 57105-1521 | 2007-05-22 |
| 1508809120 | Marwan D Hanna | Pediatrics | 1000 E. 21st St., Ste. 3100, Sioux Falls, SD 57105 | 2006-06-13 |
| 1235120403 | George Michael Maher | Pediatrics | 1600 W 22nd St, Sioux Falls, SD 57105-1521 | 2005-11-04 |
| City | SIOUX FALLS |
| Zip Code | 57105 |
Please comment or provide details below to improve the information on PEDIATRIC HEMATOLOGY CLINIC LTD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.