Individual
DR. SUHEB MASHKOOR HASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3815 PELHAM ST, STE 1, DEARBORN, MI 48124-3852
(313) 593-3915
(313) 792-8812
Mailing address
3815 PELHAM ST, STE 1, DEARBORN, MI 48124-3852
(313) 583-3915
(313) 593-3810
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301088848
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0229367
DEPT OF LABOR
MI
05
—
1140933621
—
MI
01
—
1408292901
BCBS
MI
01
—
1408294671
BC
MI
01
—
166233
GREAT LAKES
MI
01
—
39663
HEALTH PLAN OF MI
MI
01
—
P00632361
RAILROAD MEDICARE
MI
Enumeration date
08/23/2006
Last updated
01/05/2017
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