MEDICARE: IHAB H HASSAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	456527	PA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	456527	PA
3	207RP1001X	Pulmonary Disease Physician	456527	PA
4	207RP1001X	Pulmonary Disease Physician	04-42024	KS

General Provider Information

NPI Number	:	1326258682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IHAB H HASSAN M.D.

Provider Business Mailing Address
First Line	:	20375 W 151ST ST STE 451
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7210
Country	:	US
Telephone Number	:	913-829-0446
Fax Number	:	913-829-7829

Provider Business Practice Location Address
First Line	:	20375 W 151ST ST STE 451
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7210
Country	:	US
Telephone Number	:	913-829-0446
Fax Number	:	913-829-7829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/02/2019

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