Provider Demographics
NPI:1871793893
Name:HASAN, SAMAN (MD)
Entity type:Individual
Prefix:DR
First Name:SAMAN
Middle Name:
Last Name:HASAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 W WILLIAMS ST STE 106
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3979
Mailing Address - Country:US
Mailing Address - Phone:919-386-0402
Mailing Address - Fax:919-882-0931
Practice Address - Street 1:1011 W WILLIAMS ST STE 106
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3979
Practice Address - Country:US
Practice Address - Phone:919-386-0402
Practice Address - Fax:919-882-0931
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200701931174400000X, 2084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program