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NPI Code Detail

MEDICARE: HASSAN A GHANDOUR MD

MEDICARE: HASSAN A GHANDOUR MD
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
1207R00000XInternal Medicine PhysicianMD19645OR

General Provider Information

NPI Number : 1598744658
Entity Type Code : Individual
Provider Name (Legal Business Name) : HASSAN A GHANDOUR MD
Provider Business Mailing Address
First Line : 1460 G ST
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97477-4112
Country : US
Telephone Number : 541-726-4406
Fax Number : 541-744-6063
Provider Business Practice Location Address
First Line : 1460 G ST
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97477-4112
Country : US
Telephone Number : 541-726-4406
Fax Number : 541-744-6063
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2006
Last Update Date : 11/08/2016

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Directions to “ HASSAN A GHANDOUR MD” Practice Location

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