Doctor Name: | DR. GHASSAN K HATOUM |
NPI Number: | 1730226440 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | D0032495 |
Business Practice Address: | 6620 Crain Hwy Ste 104 La Plata, MD - 20646 |
Business Phone Number: | 3019342299 |
Business Fax Number: | 3013922119 |
Mailing Address: | 6620 Crain Hwy, Ste 104 LA PLATA |
State: | MD |
Postal Code: | 20646 |
Phone Number: | 3019342299 |
Fax Number: | 3013922119 |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 04/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | D0032495 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |