Healthcare Provider Details

I. General information

NPI: 1386957348
Provider Name (Legal Business Name): HAKIM MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 WEST ST
WARE MA
01082-1442
US

IV. Provider business mailing address

182 WEST ST
WARE MA
01082-1442
US

V. Phone/Fax

Practice location:
  • Phone: 413-967-5562
  • Fax: 413-967-5567
Mailing address:
  • Phone: 413-967-5562
  • Fax: 413-967-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number156847
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number219697
License Number StateMA

VIII. Authorized Official

Name: MICHAEL HAKIM
Title or Position: OWNER
Credential:
Phone: 413-967-5562