MEDICARE: SYED A HASSAN 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
1	207RG0100X	Gastroenterology Physician	01085870A	IN
2	207RG0100X	Gastroenterology Physician	036-149825	IL
3	207R00000X	Internal Medicine Physician	49214	KY
4	207RG0100X	Gastroenterology Physician	MD198461	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689098311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED A HASSAN MD

Provider Business Mailing Address
First Line	:	1078 CHESAPEAKE COVE DR
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47909-3685
Country	:	US
Telephone Number	:	312-404-6995
Fax Number	:

Provider Business Practice Location Address
First Line	:	1078 CHESAPEAKE COVE DR
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47909-3685
Country	:	US
Telephone Number	:	312-404-6995
Fax Number	:

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

Provider Enumeration Date	:	02/17/2014
Last Update Date	:	01/14/2026

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Directions to “ SYED A HASSAN MD” Practice Location

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