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NPI Code Detail

MEDICARE: MARY KATTA HAKIM M.D.

MEDICARE: MARY KATTA HAKIM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician4301086166MI
2207R00000XInternal Medicine Physician4301086166MI

General Provider Information

NPI Number : 1518168020
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KATTA HAKIM M.D.
Provider Business Mailing Address
First Line : 559 W GRAND BLVD
Second Line :
City : DETROIT
State : MI
Zip : 48216-2200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5716 MICHIGAN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48210-3039
Country : US
Telephone Number : 313-554-1095
Fax Number : 313-899-3560
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 05/18/2022

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Directions to “ MARY KATTA HAKIM M.D.” Practice Location

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