Provider Demographics
NPI:1821093865
Name:HASSAN, SHERIF (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERIF
Middle Name:
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:PO BOX 615
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-0615
Mailing Address - Country:US
Mailing Address - Phone:301-277-3555
Mailing Address - Fax:
Practice Address - Street 1:9831 GREENBELT RD
Practice Address - Street 2:STE 103
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6224
Practice Address - Country:US
Practice Address - Phone:301-277-3555
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD50862207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC955671Medicare ID - Type Unspecified
MDG54359Medicare UPIN