Provider Demographics
NPI:1487772869
Name:HASSAN, ZUBAIR UL (MD)
Entity type:Individual
Prefix:
First Name:ZUBAIR
Middle Name:UL
Last Name:HASSAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31354
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-1354
Mailing Address - Country:US
Mailing Address - Phone:800-779-0902
Mailing Address - Fax:
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1926
Practice Address - Country:US
Practice Address - Phone:804-285-6378
Practice Address - Fax:804-285-2637
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101022288174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1487772869Medicaid
VA006054641Medicaid
VA1487772869Medicaid
VA018213U97Medicare PIN
VAB09950Medicare UPIN