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Individual

DANE HASSANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
360 BROADWAY, BANGOR, ME 04401-3979
(207) 907-1430
(207) 907-3508
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8560
(207) 777-8800

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD-56101
IA
207L00000X
Anesthesiology Physician
Primary
MD23760
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036116440
IL
Enumeration date
10/03/2006
Last updated
11/05/2025
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