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General NPI Number Information
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NPI Number | 1427105907
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Entity Type | Organization
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Legal Business Name | HASAN MEDICAL INC
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 224 PROFESSIONAL PARK
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City | BECKLEY
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State | WV
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Zip | 25801-3624
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Country | US
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Telephone | 304-255-9444
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Fax | 304-255-9447
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Provider Business Mailing Address
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Address Line | 224 PROFESSIONAL PARK
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City | BECKLEY
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State | WV
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Zip | 25801-3624
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Country | US
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Telephone | 304-255-9444
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Fax | 304-255-9447
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SURAYIA T HASAN
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Credential | MD
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Telephone | 304-255-9444
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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 |
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License Number State |
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