Provider Demographics
NPI:1730179615
Name:HANNA, HAIFA (MD)
Entity type:Individual
Prefix:DR
First Name:HAIFA
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 1:6701 ROCKSIDE RD
Mailing Address - Street 2:STE 365
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2316
Mailing Address - Country:US
Mailing Address - Phone:216-901-5706
Mailing Address - Fax:216-901-6201
Practice Address - Street 1:6701 ROCKSIDE RD
Practice Address - Street 2:STE 365
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2316
Practice Address - Country:US
Practice Address - Phone:216-901-5706
Practice Address - Fax:216-901-6201
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35034136207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0260239Medicaid
OHHA0396993Medicare PIN
A74694Medicare UPIN