Individual
SHAWN POYA HASSANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 757-2927
(859) 341-0203
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 757-2927
(859) 341-0203
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
01093323A
IN
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
59355
KY
207P00000X
Emergency Medicine Physician
2022026690
MO
207P00000X
Emergency Medicine Physician
35.141219
OH
Other
Enumeration date
04/02/2018
Last updated
08/05/2024
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