Basic Information
| Provider Information | |||||||||
| NPI: | 1174843841 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMHAZ | ||||||||
| FirstName: | HASSAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1995 TECHNOLOGY PKWY | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170508522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137457233 | ||||||||
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| Address1: | 1995 TECHNOLOGY PKWY | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170508522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172318772 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2010 | ||||||||
| LastUpdateDate: | 02/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MT197252 | PA | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207LC0200X | MD456999 | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207L00000X | MD456999 | PA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 81755 | SC | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 4301098878 | MI | N | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.