MEDICARE: HOSSAM E FADEL, MD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1033165048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSSAM E FADEL, MD, PC

Provider Business Mailing Address
First Line	:	1348 WALTON WAY
Second Line	:	SUITE 5500
City	:	AUGUSTA
State	:	GA
Zip	:	30901-5104
Country	:	US
Telephone Number	:	706-724-2148
Fax Number	:	706-724-1908

Provider Business Practice Location Address
First Line	:	1348 WALTON WAY
Second Line	:	SUITE 5500
City	:	AUGUSTA
State	:	GA
Zip	:	30901-5104
Country	:	US
Telephone Number	:	706-724-2148
Fax Number	:	706-724-1908

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HOSSAM E FADEL
Credential	:	MD
Telephone Number	:	706-724-2148

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	08/22/2020

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