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Individual

MUTHANNA AL HASAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-4570
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-4570

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2012012807
MO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
4301095340
MI

Other

Enumeration date
08/27/2009
Last updated
03/06/2013
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