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General NPI Number Information
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NPI Number | 1003074212
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Entity Type | Individual
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Provider Name | AHAD MANZOOR UL HASSAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2008
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 1411 CHATTANOOGA AVE
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City | DALTON
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State | GA
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Zip | 30720-2673
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Country | US
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Telephone | 706-272-0272
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Fax |
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Provider Business Mailing Address
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Address Line | 4501 JOE RAMSEY BLVD E STE 130
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City | GREENVILLE
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State | TX
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Zip | 75401-7830
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Country | US
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Telephone | 903-201-6688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 2260
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | P8032
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License Number State | TX
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