Provider Demographics
NPI:1821391954
Name:HASSAN, MUNTASIR YOUSIF (RPH)
Entity Type:Individual
Prefix:
First Name:MUNTASIR
Middle Name:YOUSIF
Last Name:HASSAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 PARSONS RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-8436
Mailing Address - Country:US
Mailing Address - Phone:410-543-8180
Mailing Address - Fax:410-543-8966
Practice Address - Street 1:1208 PARSONS RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-8436
Practice Address - Country:US
Practice Address - Phone:410-543-8180
Practice Address - Fax:410-543-8966
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-12
Last Update Date:2010-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist