Provider Demographics
NPI:1891525309
Name:SHIDE, HASSAN BAKAD
Entity type:Individual
Prefix:MR
First Name:HASSAN
Middle Name:BAKAD
Last Name:SHIDE
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 1:4862 ROGER ALLEN CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-3832
Mailing Address - Country:US
Mailing Address - Phone:380-212-9129
Mailing Address - Fax:
Practice Address - Street 1:4862 ROGER ALLEN CT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-3832
Practice Address - Country:US
Practice Address - Phone:380-212-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant