Provider Demographics
NPI:1376047282
Name:ABOUL NOUR, HASSAN OSAMA MOSTAFA (MD)
Entity Type:Individual
Prefix:
First Name:HASSAN
Middle Name:OSAMA MOSTAFA
Last Name:ABOUL NOUR
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 1:7 HAMOUDA ST
Mailing Address - Street 2:FROM ELNADI ST. WITH ALI MOUBARAK ST.
Mailing Address - City:TANTA
Mailing Address - State:GHARBEYA
Mailing Address - Zip Code:31511
Mailing Address - Country:EG
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE STE B101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-2608
Practice Address - Country:US
Practice Address - Phone:859-323-5661
Practice Address - Fax:859-323-6411
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP4522084V0102X
390200000X
KY582472084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program