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General NPI Number Information
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NPI Number | 1093779829
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Entity Type | Individual
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Provider Name | MOHSIN HASNAIN MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 2121 LAKE AVE
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City | FORT WAYNE
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State | IN
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Zip | 46805-5100
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Country | US
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Telephone | 260-426-5431
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Fax |
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Provider Business Mailing Address
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Address Line | 3633 HERON PRESERVE TRAIL
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City | FORT WAYNE
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State | IN
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Zip | 46814-7593
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Country | US
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Telephone | 260-625-9982
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 114591
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01063362A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01063362A
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License Number State | IN
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