Provider Demographics
NPI:1093318255
Name:ALHASSAN, IBN INUSAH
Entity Type:Individual
Prefix:MR
First Name:IBN INUSAH
Middle Name:
Last Name:ALHASSAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 PLACE DE LA CONCORDE ST S
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2734
Mailing Address - Country:US
Mailing Address - Phone:917-683-6264
Mailing Address - Fax:
Practice Address - Street 1:2039 PLACE DE LA CONCORDE ST S
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2734
Practice Address - Country:US
Practice Address - Phone:917-683-6264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2573502376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker