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General NPI Number Information
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NPI Number | 1841383304
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Entity Type | Individual
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Provider Name | FARES S. HAKIM MD
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 26901 BEAUMONT BLVD STE 3D
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3849
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Country | US
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Telephone | 947-522-0688
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Fax |
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Provider Business Mailing Address
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Address Line | 4828 N DAVIS HWY
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City | PENSACOLA
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State | FL
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Zip | 32503-2341
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Country | US
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Telephone | 850-477-8109
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Fax | 850-478-2412
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0101227714
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME81200
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License Number State | FL
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