Provider Demographics
NPI:1154313377
Name:HASSAN, HASSAN ADRIAN (MD)
Entity Type:Individual
Prefix:
First Name:HASSAN
Middle Name:ADRIAN
Last Name:HASSAN
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 1:501 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6080
Mailing Address - Country:US
Mailing Address - Phone:757-826-7785
Mailing Address - Fax:757-826-9028
Practice Address - Street 1:501 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6080
Practice Address - Country:US
Practice Address - Phone:757-826-7785
Practice Address - Fax:757-826-9028
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232664207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005871093Medicaid
VA005871093Medicaid
VA100000298Medicare ID - Type Unspecified