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General NPI Number Information
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NPI Number | 1285875468
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Entity Type | Organization
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Legal Business Name | A HUDAIHED MD LLC
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 221 MCKENZIE AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-3128
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Country | US
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Telephone | 201-920-6784
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1779
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City | LYNN HAVEN
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State | FL
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Zip | 32444-5979
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Country | US
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Telephone | 201-920-6784
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALHAKAM HUDAIHED
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Credential | M.D.
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Telephone | 201-920-6784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME103502
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License Number State | FL
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