Individual
DR. HASSAN MASSOUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11995 SINGLETREE LN STE 500, EDEN PRAIRIE, MN 55344-5349
(952) 595-1301
(612) 294-4903
Mailing address
11995 SINGLETREE LN STE 500, EDEN PRAIRIE, MN 55344-5349
(952) 595-1301
(612) 294-4903
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10582
MT
2085R0202X
Diagnostic Radiology Physician
14216747-1235
UT
2085R0204X
Vascular & Interventional Radiology Physician
10582
MT
2085R0204X
Vascular & Interventional Radiology Physician
MD217314
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085442
—
MT
01
—
98815
BLUE CROSS BLUE SHIELD
MT
Enumeration date
08/30/2006
Last updated
08/27/2025
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