Basic Information
| Provider Information | |||||||||
| NPI: | 1700171527 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HASAN | ||||||||
| FirstName: | ABU | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6700 METROPOLITAN CENTER DR | ||||||||
| Address2: | APT # 510 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221504584 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5715277064 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2041 GEORGIA AVE NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028656100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2011 | ||||||||
| LastUpdateDate: | 08/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 0101255694 | VA | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 0101255694 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.