Provider Demographics
NPI:1477301927
Name:DAHSHAN, HAZEM KHALIL ISMAIL
Entity type:Individual
Prefix:MR
First Name:HAZEM
Middle Name:KHALIL ISMAIL
Last Name:DAHSHAN
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 1:1140 ASH STREET
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ISMAILIA THIRD DISTRICT EGYPT
Practice Address - Street 2:EL ZOHOUR DISTRICT EL DAWAGEN TOWER APT 205
Practice Address - City:ISMAILIA
Practice Address - State:ISMAILIA
Practice Address - Zip Code:41511
Practice Address - Country:EG
Practice Address - Phone:201-002-8209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT230596207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology