Provider Demographics
NPI:1447313085
Name:AL-HAKIM, AYMAN SALAH (MD)
Entity type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:SALAH
Last Name:AL-HAKIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1835 SAVOY DR 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1071
Mailing Address - Country:US
Mailing Address - Phone:770-228-1767
Mailing Address - Fax:770-228-7562
Practice Address - Street 1:747 S. 8TH STREET
Practice Address - Street 2:SUITE C
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4880
Practice Address - Country:US
Practice Address - Phone:770-228-1767
Practice Address - Fax:770-228-7562
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023012207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000234693QMedicaid
GA202I835650OtherMEDICARE PTAN
GA000234693GMedicaid
GA000234693PMedicaid
GA5111830002Medicare PIN