Provider Demographics
NPI:1275943425
Name:SHIHAB, HASAN MUHAMMAD (MBCHB)
Entity Type:Individual
Prefix:DR
First Name:HASAN
Middle Name:MUHAMMAD
Last Name:SHIHAB
Suffix:
Gender:M
Credentials:MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 FRANKLIN SQUARE DR
Mailing Address - Street 2:DEPARTMENT OF FAMILY MEDICINE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3901
Mailing Address - Country:US
Mailing Address - Phone:443-777-2000
Mailing Address - Fax:443-777-2034
Practice Address - Street 1:9000 FRANKLIN SQUARE DR
Practice Address - Street 2:DEPARTMENT OF FAMILY MEDICINE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:443-777-2000
Practice Address - Fax:443-777-2034
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD979582083P0901X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine