Healthcare Provider Details

I. General information

NPI: 1700172871
Provider Name (Legal Business Name): LAUREN DENISE PHYLOW HASAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN DENISE PHYLOW ALLAN DO

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

PO BOX 751069
CHARLOTTE NC
28275-1069
US

V. Phone/Fax

Practice location:
  • Phone: 252-816-0600
  • Fax: 252-816-0721
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO-04656
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2022-01791
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR-9282
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberDO-04656
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberDO-04656
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: