Provider Demographics
NPI:1043447576
Name:JOHN P HAKIM MD & ASSOCIATES PA
Entity type:Organization
Organization Name:JOHN P HAKIM MD & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PIERRE
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-880-5146
Mailing Address - Street 1:3195 LACROSSE CT
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-2926
Mailing Address - Country:US
Mailing Address - Phone:443-880-5146
Mailing Address - Fax:301-856-5454
Practice Address - Street 1:135 W DARES BEACH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3119
Practice Address - Country:US
Practice Address - Phone:443-880-5146
Practice Address - Fax:301-856-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 207RC0000X
MDD47748207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD159458ZD6Medicare UPIN
MDG45273Medicare UPIN