MEDICARE: FATIMA 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	W1802	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1659804284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA HASSAN M.D.

Provider Business Mailing Address
First Line	:	7556 CRYSTAL LAKE DRIVE CORDOVA 38016 TN
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-0001
Country	:	US
Telephone Number	:	901-448-5814
Fax Number	:

Provider Business Practice Location Address
First Line	:	7556 CRYSTAL LAKE DRIVE CORDOVA 38016 TN
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-0001
Country	:	US
Telephone Number	:	240-505-2102
Fax Number	:

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

Provider Enumeration Date	:	04/11/2017
Last Update Date	:	02/03/2026

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