Provider Demographics
NPI:1386859205
Name:HASAN, MAZEN (MD)
Entity type:Individual
Prefix:DR
First Name:MAZEN
Middle Name:
Last Name:HASAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:840 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7023
Mailing Address - Country:US
Mailing Address - Phone:540-552-1353
Mailing Address - Fax:540-443-0535
Practice Address - Street 1:83 HILLCREST DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2605
Practice Address - Country:US
Practice Address - Phone:814-938-3503
Practice Address - Fax:814-938-4525
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2022-01-04
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Provider Licenses
StateLicense IDTaxonomies
VA0101271162208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology