Provider Demographics
NPI:1801863386
Name:HASAN, SAMINA Z (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMINA
Middle Name:Z
Last Name:HASAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6800 W CENTRAL AVE
Mailing Address - Street 2:UNIT K
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1135
Mailing Address - Country:US
Mailing Address - Phone:419-841-1510
Mailing Address - Fax:419-841-1513
Practice Address - Street 1:6800 W CENTRAL AVE
Practice Address - Street 2:UNIT K
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1135
Practice Address - Country:US
Practice Address - Phone:419-841-1510
Practice Address - Fax:419-841-1513
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2011-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35061565207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0905257Medicaid
OHP00144061OtherRAIROAD MEDICARE
OH0905257Medicaid
OHHA0699847Medicare PIN