Provider Demographics
NPI:1730510405
Name:HAMDAN, HASSAN (CSFA)
Entity type:Individual
Prefix:MR
First Name:HASSAN
Middle Name:
Last Name:HAMDAN
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8560 N SILVERY LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-4515
Mailing Address - Country:US
Mailing Address - Phone:313-581-3255
Mailing Address - Fax:313-581-3755
Practice Address - Street 1:8560 N SILVERY LN
Practice Address - Street 2:SUITE 202
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-4515
Practice Address - Country:US
Practice Address - Phone:313-581-3255
Practice Address - Fax:313-581-3755
Is Sole Proprietor?:No
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13-222246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant