Provider Demographics
NPI:1447020680
Name:DR F M HIMADA AND PEDIATRIC ASSOCIATES LLC
Entity type:Organization
Organization Name:DR F M HIMADA AND PEDIATRIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAWZI
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIMADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-273-5575
Mailing Address - Street 1:811 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-3219
Mailing Address - Country:US
Mailing Address - Phone:229-273-5575
Mailing Address - Fax:229-273-5075
Practice Address - Street 1:811 N 4TH ST
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3219
Practice Address - Country:US
Practice Address - Phone:229-273-5575
Practice Address - Fax:229-273-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty