Provider Demographics
NPI:1679541502
Name:HASNI, SARFARAZ (MD)
Entity type:Individual
Prefix:
First Name:SARFARAZ
Middle Name:
Last Name:HASNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 CASINO CIR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5902
Mailing Address - Country:US
Mailing Address - Phone:301-451-1599
Mailing Address - Fax:301-451-5655
Practice Address - Street 1:1427 CASINO CIR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5902
Practice Address - Country:US
Practice Address - Phone:301-451-1599
Practice Address - Fax:301-451-5655
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071945207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4718398Medicaid
MI4718398Medicaid
MIM52880004Medicare ID - Type Unspecified