Provider Demographics
NPI:1003809633
Name:HASHMI, MASUD SHAH (MD)
Entity Type:Individual
Prefix:
First Name:MASUD
Middle Name:SHAH
Last Name:HASHMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-1175
Mailing Address - Country:US
Mailing Address - Phone:919-425-1565
Mailing Address - Fax:919-425-0478
Practice Address - Street 1:500 E POTTAWATAMIE ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-2018
Practice Address - Country:US
Practice Address - Phone:517-424-3050
Practice Address - Fax:517-424-3613
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00485207P00000X
OH34044042208600000X
MI4301089254208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH04243OtherPHC
OH000000273571OtherANTHEM
OH0431741Medicaid
OH17-02521OtherUHC
OH020053922OtherRRMC
OH4092334OtherAETNA
OH17-02521OtherUHC
OH0431741Medicaid
OH020053922OtherRRMC