Provider Demographics
NPI:1770541229
Name:TAHHAN, HASSAN R (MD)
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:R
Last Name:TAHHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:600 GRESHAM DR
Mailing Address - Street 2:SENTARA NORFOLK GENERAL HOSPITAL PATH DEPT
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1904
Mailing Address - Country:US
Mailing Address - Phone:757-388-3221
Mailing Address - Fax:757-388-3799
Practice Address - Street 1:600 GRESHAM DR
Practice Address - Street 2:SENTARA NORFOLK GENERAL HOSPITAL PATH DEPT
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-3221
Practice Address - Fax:757-388-3799
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101049654207ZB0001X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1770541229Medicaid
220000603Medicare PIN
VA006603271Medicaid