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General NPI Number Information
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NPI Number | 1932297702
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Entity Type | Individual
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Provider Name | MOHAMMAD REZA ABOLHASSANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 830 KEMPSVILLE RD FL 1
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City | NORFOLK
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State | VA
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Zip | 23502-3920
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Country | US
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Telephone | 757-261-8070
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Fax | 757-995-7095
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Provider Business Mailing Address
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Address Line | 830 KEMPSVILLE RD FL 1
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City | NORFOLK
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State | VA
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Zip | 23502-3920
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Country | US
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Telephone | 757-261-8070
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Fax | 757-995-7095
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101242569
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101242569
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License Number State | VA
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