Healthcare Provider Details

I. General information

NPI: 1225680978
Provider Name (Legal Business Name): HASSAN LIAQAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 HANNAH BLVD STE 114
EAST LANSING MI
48823-5380
US

IV. Provider business mailing address

2900 HANNAH BLVD STE 114
EAST LANSING MI
48823-5380
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-6256
  • Fax:
Mailing address:
  • Phone: 517-364-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number4301510363
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: