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NPI Code Detail

MEDICARE: DR. MOHAMED HASSAN HALANE M.D

MEDICARE: DR. MOHAMED HASSAN HALANE 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
1207R00000XInternal Medicine Physician70739MN
2390200000XStudent in an Organized Health Care Education/Training Program
3208M00000XHospitalist Physician70739MN

General Provider Information

NPI Number : 1639306442
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMED HASSAN HALANE M.D
Provider Business Mailing Address
First Line : 4485 BARAT HALL DR
Second Line : APT. C1
City : SAINT LOUIS
State : MO
Zip : 63108-2557
Country : US
Telephone Number : 908-875-3508
Fax Number :
Provider Business Practice Location Address
First Line : 1465 S GRAND BLVD
Second Line : ROOM 1206
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-577-5634
Fax Number : 314-577-5616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2009
Last Update Date : 08/22/2022

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