Healthcare Provider Details

I. General information

NPI: 1487601746
Provider Name (Legal Business Name): AKBER H HASHIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 FIVE FORKS TRICKUM RD SUITE 204
LIBURN GA
30047
US

IV. Provider business mailing address

3100 FIVE FORKS TRICKUM RD SW SUITE 204
LILBURN GA
30047-1890
US

V. Phone/Fax

Practice location:
  • Phone: 770-978-7701
  • Fax: 770-978-7822
Mailing address:
  • Phone: 770-978-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number043638
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: