Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301074090 | MI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 4301074090 | MI |
NPI | 1083722052 |
---|---|
Provider Name | Dr. Hassan Ali Hammoud |
First Address | Dearborn, MI 48126-3251 |
Second Address | Dearborn, MI 48126-3251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H87234 | (02) | MI |