Provider Demographics
NPI:1841492188
Name:HASAN, SYED Z (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:Z
Last Name:HASAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 JACOB LN
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-1776
Mailing Address - Country:US
Mailing Address - Phone:763-587-4200
Mailing Address - Fax:763-587-4205
Practice Address - Street 1:2855 CAMPUS DR STE 400
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2659
Practice Address - Country:US
Practice Address - Phone:763-577-7400
Practice Address - Fax:763-236-2650
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN55912207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G89261Medicare UPIN
ND14675Medicaid
NDN713402Medicare PIN