Provider Demographics
NPI:1154347607
Name:HASAN, OMAR K (MD)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:K
Last Name:HASAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:252 RURAL ACRES DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3503
Mailing Address - Country:US
Mailing Address - Phone:304-252-8409
Mailing Address - Fax:304-252-0022
Practice Address - Street 1:28 MALLARD CT
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3664
Practice Address - Country:US
Practice Address - Phone:304-252-8409
Practice Address - Fax:304-252-0022
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2025-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV216932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810009063Medicaid
WV3810009063Medicaid
WVHA4212451Medicare PIN