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General NPI Number Information
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NPI Number | 1346226453
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Entity Type | Individual
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Provider Name | HOSSAN A HASSAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 1035 CHERAW ST.
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City | BENNETTSVILLE
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State | SC
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Zip | 29512
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Country | US
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Telephone | 843-454-0442
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Fax | 843-777-6871
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Provider Business Mailing Address
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Address Line | P.O. BOX 918
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City | BENNETTSVILLE
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State | SC
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Zip | 29512
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Country | US
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Telephone | 843-454-0841
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Fax | 815-654-8020
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23135
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD23135
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License Number State | SC
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