Healthcare Provider Details

I. General information

NPI: 1336183060
Provider Name (Legal Business Name): ZUBAIR HASSAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 E KELLOGG DR
WICHITA KS
67218-1607
US

IV. Provider business mailing address

2543 N WILDERNESS CT
WICHITA KS
67226-2140
US

V. Phone/Fax

Practice location:
  • Phone: 316-685-2221
  • Fax: 316-681-5522
Mailing address:
  • Phone: 316-644-8732
  • Fax: 316-630-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0427325
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0427325
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: