Provider Demographics
NPI:1801974506
Name:YASEEN HASHISH, M.D., P.C.
Entity type:Organization
Organization Name:YASEEN HASHISH, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YASEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-230-9717
Mailing Address - Street 1:5031 VILLA LINDE PKWY
Mailing Address - Street 2:SUITE 34
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3446
Mailing Address - Country:US
Mailing Address - Phone:810-230-9717
Mailing Address - Fax:
Practice Address - Street 1:5031 VILLA LINDE PKWY
Practice Address - Street 2:SUITE 34
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3446
Practice Address - Country:US
Practice Address - Phone:810-230-9717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079267207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1102510672OtherBLUE CROSS BLUE SHIELD
MI4588678Medicaid
MI0N84080Medicare ID - Type Unspecified
MI4588678Medicaid