Provider Demographics
NPI:1073538849
Name:HASSEN, IRFAN (MD)
Entity Type:Individual
Prefix:
First Name:IRFAN
Middle Name:
Last Name:HASSEN
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 1:801 TOLL HOUSE AVE
Mailing Address - Street 2:SUITE D2
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4564
Mailing Address - Country:US
Mailing Address - Phone:301-698-2604
Mailing Address - Fax:301-698-5307
Practice Address - Street 1:801 TOLL HOUSE AVE
Practice Address - Street 2:SUITE D2
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4564
Practice Address - Country:US
Practice Address - Phone:301-698-2604
Practice Address - Fax:301-698-5307
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0034303207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine