Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 2005989A | IN |
NPI | 1023428877 |
---|---|
Provider Name | Ammar Hassan |
First Address | Highland, IN 46322-3616 |
Second Address | Highland, IN 46322-3616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2014 |
Last Update Date | 28/01/2022 |