Individual
HASSAN ISHAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 364-1000
Mailing address
730 IRONWOOD DR APT 305, ROCHESTER, MI 48307-1320
(507) 405-9546
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01089255A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2020
Last updated
07/20/2023
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