Healthcare Provider Details

I. General information

NPI: 1376771626
Provider Name (Legal Business Name): HASSAN M NASIR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1277 E CEDAR AVE
GLADWIN MI
48624-7004
US

IV. Provider business mailing address

30060 BRISTOL LN
BINGHAM FARMS MI
48025-4601
US

V. Phone/Fax

Practice location:
  • Phone: 989-343-5037
  • Fax:
Mailing address:
  • Phone: 248-890-8711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101018446
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS11877
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number36135769
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number5101018446
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number5101018446
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: