Basic Information
| Provider Information | |||||||||
| NPI: | 1508809120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANNA | ||||||||
| FirstName: | MARWAN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 86370 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571186370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E. 21ST ST., | ||||||||
| Address2: | STE. 3100 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 57105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227595 | ||||||||
| FaxNumber: | 6053227599 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 02/25/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0207X | 1562 | SD | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology |
ID Information
| ID | Type | State | Issuer | Description | 1973479 | 05 | IA | MEDICAID | 46022474339 | 05 | NE | MEDICAID | 13414 | 05 | ND | MEDICAID | 3600663 | 01 | SD | MEDICA | OTHER | 533P7HA | 01 | MN | BLUE CROSS | OTHER | 533P7HA | 01 | MN | CC SYSTEMS/ BLUE PLUS | OTHER | 57105I015 | 01 | SD | WPS TRICARE | OTHER | 747066 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 4993984 | 01 | SD | BLUE CROSS | OTHER | 722801030514 | 01 | SD | PREFERRED ONE | OTHER | 2642 | 01 | SD | MIDLANDS CHOICE | OTHER | 1562 | 01 | SD | DAKOTACARE | OTHER | HP63510 | 01 | SD | HEALTHPARTNERS | OTHER |