Healthcare Provider Details
I. General information
NPI: 1649224551
Provider Name (Legal Business Name): FAWAZ ZAKAI HAKKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 E MAIN ST
WAYNESBORO PA
17268-2353
US
IV. Provider business mailing address
785 5TH AVENUE SUITE 3
CHAMBERSBURG PA
17201-4232
US
V. Phone/Fax
- Phone: 717-765-3648
- Fax: 717-765-3647
- Phone: 717-263-9555
- Fax: 717-217-4218
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD429143 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0008X |
| Taxonomy | Hepatology Physician |
| License Number | MD429143 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | MD429143 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: