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General NPI Number Information
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NPI Number | 1942481643
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Entity Type | Individual
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Provider Name | MUSTAFA HASSAN MAHMOUD HASSAN MBBS
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Gender | Male
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1386 S LINDEN RD
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City | FLINT
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State | MI
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Zip | 48532-4185
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Country | US
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Telephone | 810-285-8501
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Fax | 810-285-8468
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Provider Business Mailing Address
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Address Line | 1386 S LINDEN RD
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City | FLINT
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State | MI
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Zip | 48532-4185
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Country | US
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Telephone | 810-285-8501
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Fax | 810-285-8468
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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 | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 4301089453
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301089453
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME 96984
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License Number State | FL
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