Basic Information
| Provider Information | |||||||||
| NPI: | 1821230178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HASSAN | ||||||||
| FirstName: | WAEL | ||||||||
| MiddleName: | SALAHELDIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9900 N CENTRAL EXPY STE 215 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752310929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143964950 | ||||||||
| FaxNumber: | 2146132925 | ||||||||
| Practice Location | |||||||||
| Address1: | 3003 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | MARINETTE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 541434110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7157354200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2009 | ||||||||
| LastUpdateDate: | 01/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 55397-20 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 55397 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.