Healthcare Provider Details

I. General information

NPI: 1841434404
Provider Name (Legal Business Name): HATEM FIKRY AHMED HAMED M.D.,M.B.,CH.B.,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 GATEWAY DR STE B
SLIDELL LA
70461-5598
US

IV. Provider business mailing address

310 GATEWAY DR STE B
SLIDELL LA
70461-5598
US

V. Phone/Fax

Practice location:
  • Phone: 724-708-5577
  • Fax: 985-288-0559
Mailing address:
  • Phone: 724-708-5577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.206408
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number051743
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA123745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: