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General NPI Number Information
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NPI Number | 1780856187
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Entity Type | Organization
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Legal Business Name | M. HASSAN DIAB, M.D., S.C.
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2560 24TH ST SUITE 201
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City | ROCK ISLAND
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State | IL
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Zip | 61201-5357
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Country | US
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Telephone | 309-779-7491
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Fax | 309-779-3093
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Provider Business Mailing Address
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Address Line | 2560 24TH ST SUITE 201
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City | ROCK ISLAND
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State | IL
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Zip | 61201-5357
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Country | US
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Telephone | 309-779-7491
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Fax | 309-779-3093
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MOHAMED HASSAN DIAB
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Credential | M.D.
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Telephone | 309-779-7491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 3651347
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License Number State | IL
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