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General NPI Number Information
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NPI Number | 1376843094
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Entity Type | Organization
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Legal Business Name | HASSAN KASSAMALI, MD PA
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 17 FONTANA LN SUITE 101
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City | ROSEDALE
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State | MD
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Zip | 21237-3017
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Country | US
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Telephone | 410-687-0000
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Fax | 410-391-8656
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Provider Business Mailing Address
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Address Line | 17 FONTANA LN SUITE 101
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City | ROSEDALE
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State | MD
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Zip | 21237-3017
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Country | US
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Telephone | 410-687-0000
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Fax | 410-391-8656
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Authorized Official
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Title or Position | PHYSICIAN
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Name | HASSAN KASSAMALI
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Credential | M.D., PA
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Telephone | 410-687-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | D0046126
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License Number State | MD
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