MEDICARE: WILLIAM M HASBUN 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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	MA05605800	NJ
2	207R00000X	Internal Medicine Physician	MA05605800	NJ
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	ME154619	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295762466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM M HASBUN MD

Provider Business Mailing Address
First Line	:	2055 GROVE DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-7575
Country	:	US
Telephone Number	:	856-577-6627
Fax Number	:	239-304-9805

Provider Business Practice Location Address
First Line	:	5068 ANNUNCIATION CIR UNIT 111
Second Line	:
City	:	AVE MARIA
State	:	FL
Zip	:	34142-9668
Country	:	US
Telephone Number	:	239-867-4395
Fax Number	:	239-217-3662

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	03/20/2023

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Directions to “ WILLIAM M HASBUN MD” Practice Location

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