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NPI Code Detail

MEDICARE: MAHAMUD HASSAN

MEDICARE:   MAHAMUD  HASSAN
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
1246QL0900XLaboratory Management Specialist/TechnologistOH

General Provider Information

NPI Number : 1811396740
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAHAMUD HASSAN
Provider Business Mailing Address
First Line : PO BOX 247824
Second Line :
City : COLUMBUS
State : OH
Zip : 43224-7824
Country : US
Telephone Number : 614-596-7808
Fax Number : 614-319-5050
Provider Business Practice Location Address
First Line : 4661 CLEVELAND AVE BLDG A
Second Line :
City : COLUMBUS
State : OH
Zip : 43231-5848
Country : US
Telephone Number : 614-269-7612
Fax Number : 614-319-5050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2014
Last Update Date : 08/15/2014

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