DR. MARK CHARLES HANNIBAL (NPI# 1548350432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548350432 |
| Entity Type | Individual |
| Full Name | DR. MARK CHARLES HANNIBAL |
| Credential | M.D., PH.D. |
| Practice Address |
1500 E Medical Center Dr 6th Floor Mott Childrens Hospital Ann Arbor MI 48109-4259 |
| Mailing Address |
3621 S State St 700 Kms Place Ann Arbor MI 48108 |
| Practice Telephone | 7349364185 |
| Mailing Telephone | 7349362047 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
4301099786 | MI | Allopathic & Osteopathic Physicians |
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
MD00037850 | WA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 4301099786 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INTERNAL ID-MOTOR VEHICLE ID | 3199 | 01 | |
| WA | 8246647 | 05 |
| Street Address |
1500 E MEDICAL CENTER DR 6TH FLOOR MOTT CHILDRENS HOSPITAL |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48109-4259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669475836 | Tami L. Remington | Pharmacist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-0999 | 2005-05-23 |
| 1578164810 | Jessica Leigh Bailey | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-11-03 |
| 1518565910 | Yoshiaki Ota | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-10-16 |
| 1366058356 | Paulo Zupelari Goncalves | Dentist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-09-16 |
| 1306459466 | Jesse P Spalding | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-28 |
| 1992318919 | Batoul Berri | Audiologist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-28 |
| 1063024891 | Nathan Allen Johnson | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-22 |
| 1780296699 | Yoav Hammer | Internal Medicine | 1500 E Medical Center Dr, 2nd Floor, Cardiovascular Center, Ann Arbor, MI 48109-5853 | 2020-08-21 |
| 1891306262 | Sarah Garnai | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-11 |
| 1386254936 | Ryan James Sutherlan | Pharmacist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-08-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558987024 | Albert Byun | Student in an Organized Health Care Education/Training Program | 1500 E.medical Center Dr., 1h247, Ann Arbor, MI 48109 | 2020-06-22 |
| 1851914931 | Nadine Ibrahim | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Spc 5312, Taubman Center, 1st Floor, Room 1903, Ann Arbor, MI 48109 | 2020-05-22 |
| 1568083350 | Tucker Zimmer | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-03 |
| 1144841099 | Jessica Moore Meves | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-01 |
| 1710522297 | Xiaoyuan Hu | Specialist/Technologist | Obl 2150, 1402 Washington Hts, Ann Arbor, MI 48109 | 2019-11-08 |
| 1376192401 | Regina Kay Freeman | Clinical Nurse Specialist | 4726 Cardiovascular Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109 | 2019-09-11 |
| 1477114155 | William Philip Saunders IIi | Student in an Organized Health Care Education/Training Program | 300 N Ingalls Building, Rm Ni4co6, Ann Arbor, MI 48109 | 2019-06-24 |
| 1093290447 | Teresa H Lyden | Speech-Language Pathologist | 1500 E. Medical Center Dr., Spc 5312, 1904 Tc, Otolaryngology-head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1649755091 | Anna Grace Hardenbergh | Speech-Language Pathologist | 1500 E. Medical Center Drive Tc 1904, Otolaryngology Head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| 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/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811553597 | Emile Muallem | Pediatrics | 1500 E. Med. Ctr Dr, Ann Arbor, MI 48109-5718 | 2019-05-17 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
| 1396239992 | Christina Sloan-heggen | Pediatrics | 1500 E. Medical Center Drive., Medical Professional Building D-3230, Ann Arbor, MI 48109 | 2018-06-18 |
| 1568955730 | Alexander Sliwicki | Pediatrics | 1500 East Medical Drive, Medical Professional Building, Ann Arbor, MI 48105 | 2018-06-12 |
| 1528598489 | Allison Shewmake | Pediatrics | 1500 E Med Ctr Dr, Spc 5718, Ann Arbor, MI 48109-5718 | 2017-06-14 |
| 1821528928 | Caroline West | Pediatrics | 1500 E. Med. Ctr. Dr., Spc 5718, Ann Arbor, MI 48109-5718 | 2017-06-13 |
| 1083142418 | Aaron M. Schuh | Pediatrics | 1600 E. Med. Ctr. Dr., Mpb Spc 5718, Ann Arbor, MI 48109-5718 | 2017-05-30 |
| 1154858769 | Hira Rashid | Pediatrics | 1500 E. Medical Ctr. Dr., Spc 5718, Ann Arbor, MI 48109-5718 | 2017-05-12 |
| 1225443609 | David Svilar | Pediatrics | 1500 E Medical Center Dr Rm D4202, Ann Arbor, MI 48109-5000 | 2014-06-24 |
| 1669885125 | Phoebe Day Danziger | Pediatrics | 400 E Eisenhower Pkway, Ann Arbor, MI 48108-3302 | 2014-06-03 |
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| 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.