Provider Demographics
NPI:1932180437
Name:HASSAN, BASIL S (MD)
Entity Type:Individual
Prefix:
First Name:BASIL
Middle Name:S
Last Name:HASSAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:230 S 68TH ST
Mailing Address - Street 2:SUITE 1203
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8176
Mailing Address - Country:US
Mailing Address - Phone:515-471-1800
Mailing Address - Fax:515-471-1801
Practice Address - Street 1:230 S 68TH ST
Practice Address - Street 2:SUITE 1203
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8176
Practice Address - Country:US
Practice Address - Phone:515-471-1800
Practice Address - Fax:515-471-1801
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2009-12-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA35490207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI02637Medicare UPIN