Individual
DR. MOHAMMED K HASNAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
207 SPARKS AVE STE 300, JEFFERSONVILLE, IN 47130-3739
(812) 218-7978
(812) 218-6589
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01057455A
IN
2084N0400X
Neurology Physician
01057455A
IN
2084N0600X
Clinical Neurophysiology Physician
Primary
01057455A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01057455A
STATE LICENSE
IN
05
—
200430120
—
IN
01
—
44372
STATE LICENSE
KY
05
—
7100236450
—
KY
Enumeration date
05/27/2005
Last updated
02/07/2024
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