Individual
MOHAMMAD A S A HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBCHB
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
(650) 750-0615
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4301501156
MI
2085R0001X
Radiation Oncology Physician
A167946
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301501156
MICHIGAN LICENSE
MI
Enumeration date
08/04/2019
Last updated
12/04/2024
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