Martin E Hanawalt, MD | |
335 Glessner Ave, Mansfield, OH 44903-2269 | |
(419) 526-8533 | |
Not Available |
Full Name | Martin E Hanawalt |
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Gender | Male |
Speciality | Pediatrics |
Location | 335 Glessner Ave, Mansfield, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811967185 | NPI | - | NPPES |
0128810 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208M00000X | Hospitalist | 35071705 (Ohio) | Secondary |
208000000X | Pediatrics | 35.071705 (Ohio) | Primary |
Entity Name | Pediatric Academic Association, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063419943 PECOS PAC ID: 2961306774 Enrollment ID: O20031124000198 |
Mailing Address | Practice Location Address |
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Martin E Hanawalt, MD 700 Childrens Dr, Columbus, OH 43205-2664 Ph: (614) 722-2000 | Martin E Hanawalt, MD 335 Glessner Ave, Mansfield, OH 44903-2269 Ph: (419) 526-8533 |
Peter M O'day, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 335 Glessner Ave, Mansfield, OH 44903 Phone: 419-526-8136 | |
Achilles E Litao, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1029 S Trimble Rd, Mansfield, OH 44906 Phone: 419-522-3341 Fax: 419-522-1110 | |
Dr. Robert David Burns, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1029 S Trimble Rd, Mansfield, OH 44906 Phone: 419-522-3341 Fax: 419-522-1110 | |
Dr. Wade Wallace Wilde, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1029 S Trimble Rd, Mansfield, OH 44906 Phone: 419-521-2950 Fax: 419-522-0837 | |
Colleen J Mckinney, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 540 S Trimble Rd, Mansfield, OH 44906 Phone: 419-522-5454 Fax: 419-522-2981 | |
Dr. Celia Jane Flinn, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1029 S Trimble Rd, Mansfield, OH 44906 Phone: 419-522-3341 Fax: 419-522-1110 | |
Chandra R. Shaker, M.D., F.A.A.P. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 120 Sturges Ave Ste 1, Mansfield, OH 44903 Phone: 419-522-5454 Fax: 419-522-2981 |