Individual provider · Type 1 NPI

John Jacob Hannibal Iv, MD

Student in an Organized Health Care Education/Training Program · Buffalo, NY

NPI number 1003133729 Active

Practice location

462 Grider St
Buffalo, NY 14215-3021

Call (716) 898-4226 Map

Fax (716) 898-3279

Mailing address

3348 Wallace Dr
Grand Island, NY 14072-1032

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1003133729

John Jacob Hannibal Iv, MD's National Provider Identifier is 1003133729, issued on Apr 21, 2010. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Buffalo, NY. The record was last updated on Apr 21, 2010.