Healthcare Provider Details

I. General information

NPI: 1174733695
Provider Name (Legal Business Name): MOHAMMEDHASAN I SARAWAN M.B., B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8520 LONG MEADOW LN
JOHNSTON IA
50131-2879
US

IV. Provider business mailing address

8520 LONG MEADOW LN
JOHNSTON IA
50131-2879
US

V. Phone/Fax

Practice location:
  • Phone: 212-961-6200
  • Fax:
Mailing address:
  • Phone: 212-961-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR7736
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-37767
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: