Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | MA05605800 | NJ |
N | 207R00000X | Internist | MA05605800 | NJ |
N | 111NI0900X | Internist | MA05605800 | NJ |
NPI | 1295762466 |
---|---|
Provider Name | William M Hasbun |
First Address | Mount Laurel, NJ 08054 |
Second Address | Collingswood, NJ 08108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5209307 | (05) | NJ |
E99900 | (02) |