Provider Demographics
NPI:1083605190
Name:HAGGAG, AKRAM IBRAHIEM (MD)
Entity Type:Individual
Prefix:DR
First Name:AKRAM
Middle Name:IBRAHIEM
Last Name:HAGGAG
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 1:708 WILL HALSEY WAY STE A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2566
Mailing Address - Country:US
Mailing Address - Phone:256-325-2763
Mailing Address - Fax:
Practice Address - Street 1:708 WILL HALSEY WAY STE A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2566
Practice Address - Country:US
Practice Address - Phone:256-325-2763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026320207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051555590Medicaid
H03379Medicare UPIN
AL051555590Medicaid