MEDICARE: DR. NOSHEEN HASAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LA0401X	Addiction Medicine (Anesthesiology) Physician	44667-020	WI
2	208VP0014X	Interventional Pain Medicine Physician	44667-020	WI
3	207L00000X	Anesthesiology Physician	44667-020	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003800285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOSHEEN HASAN MD

Provider Business Mailing Address
First Line	:	6200 W CENTER ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2159
Country	:	US
Telephone Number	:	414-444-8670
Fax Number	:	414-444-8678

Provider Business Practice Location Address
First Line	:	6200 W CENTER ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2159
Country	:	US
Telephone Number	:	414-444-8670
Fax Number	:	414-444-8678

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	12/18/2025

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