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General NPI Number Information
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NPI Number | 1811203615
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Entity Type | Individual
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Provider Name | FAYAD HAMIDEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | BLUEWATER HEALTH 89 NORMAN STREET
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City | SARNIA
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State | ONTARIO
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Zip | N7T 6S3
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Country | CA
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Telephone | 226-776-3306
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Fax | 801-365-5170
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Provider Business Mailing Address
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Address Line | BLUEWATER HEALTH 89 NORMAN STREET
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City | SARNIA
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State | ONTARIO
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Zip | N7T 6S3
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Country | CA
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Telephone | 226-776-3306
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Fax | 801-365-5170
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A056254
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301095301
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License Number State | MI
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