Healthcare Provider Details

I. General information

NPI: 1073001921
Provider Name (Legal Business Name): BILAL HASAN MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 GEIPE RD
CATONSVILLE MD
21228-4147
US

IV. Provider business mailing address

11375 CORTEZ BLVD
BROOKSVILLE FL
34613-5409
US

V. Phone/Fax

Practice location:
  • Phone: 410-744-0661
  • Fax: 410-744-8036
Mailing address:
  • Phone: 352-596-6632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMD210002459
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN26267
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberD0092266
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD92266
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: