Individual
HASSAN SOUIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 FINANCIAL PL STE 210, ELIZABETHTOWN, KY 42701-8403
(270) 706-5515
(270) 706-5516
Mailing address
1350 W BETHUNE ST APT 2101, DETROIT, MI 48202-2667
(270) 706-5515
(270) 706-5516
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
60190
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2020
Last updated
06/09/2025
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