MEDICARE: DR. JALAL EDDIN HAKMEI 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
1	207RN0300X	Nephrology Physician	98846	GA
2	207RN0300X	Nephrology Physician	35.149673	OH
3	207R00000X	Internal Medicine Physician	125060198	IL
4	207RN0300X	Nephrology Physician	36627	SC

General Provider Information

NPI Number	:	1730468570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JALAL EDDIN HAKMEI M.D.

Provider Business Mailing Address
First Line	:	3031 SAINT MATTHEWS RD
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29118-1443
Country	:	US
Telephone Number	:	803-531-2677
Fax Number	:	803-531-6137

Provider Business Practice Location Address
First Line	:	3031 SAINT MATTHEWS RD
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29118-1443
Country	:	US
Telephone Number	:	803-531-2677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2011
Last Update Date	:	12/16/2025

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