Provider Demographics
NPI:1194467233
Name:STREETER, HANNAH (DO)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:STREETER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5473 SANDLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WATERFORD TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48329-3487
Mailing Address - Country:US
Mailing Address - Phone:219-263-8945
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD OFC
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2689
Practice Address - Country:US
Practice Address - Phone:313-916-8372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-09
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101028898207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine