Individual
SYED MUSTAFA HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 MERCER AVE, DECATUR, IN 46733-2303
(260) 724-2145
(260) 728-3852
Mailing address
300 S BRUCE ST, AVERA MARSHALL, MARSHALL, MN 56258-1934
(507) 537-9300
(507) 537-9356
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01072973A
IN
207P00000X
Emergency Medicine Physician
58354
MN
207Q00000X
Family Medicine Physician
01072973A
IN
Other
Enumeration date
06/17/2011
Last updated
03/29/2022
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