Provider Demographics
NPI:1013400407
Name:HASAN, SYED SAFDER ABBAS (MD)
Entity Type:Individual
Prefix:MR
First Name:SYED SAFDER ABBAS
Middle Name:
Last Name:HASAN
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 1:1364 CLIFTON ROAD, NE
Mailing Address - Street 2:OFFICE OF SURGICAL EDUCATION, SUITE H100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-727-0093
Mailing Address - Fax:404-712-0561
Practice Address - Street 1:1364 CLIFTON ROAD, NE
Practice Address - Street 2:OFFICE OF SURGICAL EDUCATION, SUITE H100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-727-0093
Practice Address - Fax:404-712-0561
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2019-05-08
Deactivation Date:2019-01-25
Deactivation Code:
Reactivation Date:2019-05-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program