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NPI Code Detail

MEDICARE: DR. ALI HASAN MD

MEDICARE: DR. ALI HASAN 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
1390200000XStudent in an Organized Health Care Education/Training ProgramMD

General Provider Information

NPI Number : 1609718410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALI HASAN MD
Provider Business Mailing Address
First Line : 2806 CONRAD DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-3500
Country : US
Telephone Number : 614-929-8666
Fax Number :
Provider Business Practice Location Address
First Line : 901 HARRY S TRUMAN DR N
Second Line :
City : LARGO
State : MD
Zip : 20774-5477
Country : US
Telephone Number : 240-677-0021
Fax Number : 240-677-0028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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