Provider Demographics
NPI:1073550786
Name:HAMED, HUSAM (MD)
Entity Type:Individual
Prefix:
First Name:HUSAM
Middle Name:
Last Name:HAMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3645 STONECREEK BLVD UNIT E
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1469
Mailing Address - Country:US
Mailing Address - Phone:513-687-0500
Mailing Address - Fax:513-598-1107
Practice Address - Street 1:3035 HAMILTON MASON RD STE 203
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-5545
Practice Address - Country:US
Practice Address - Phone:513-741-7200
Practice Address - Fax:513-741-1977
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36543207Q00000X
OH35079659207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64038581Medicaid
OH2565399Medicaid
OH2293825Medicaid
OHP00339417Medicare PIN
H43793Medicare UPIN
KY00827001Medicare PIN
OH4056815Medicare PIN