Provider Demographics
NPI:1063125425
Name:ADNAN, ADNAN GHASSAN
Entity type:Individual
Prefix:
First Name:ADNAN
Middle Name:GHASSAN
Last Name:ADNAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HILL ST # 301
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-5133
Mailing Address - Country:US
Mailing Address - Phone:207-776-9704
Mailing Address - Fax:
Practice Address - Street 1:30 HILL ST # 301
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-5133
Practice Address - Country:US
Practice Address - Phone:207-776-9704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide