Provider Demographics
NPI:1144424623
Name:HADID, TARIK HIKMAT (MD)
Entity Type:Individual
Prefix:DR
First Name:TARIK
Middle Name:HIKMAT
Last Name:HADID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11900 E 12 MILE RD STE 308
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-3491
Mailing Address - Country:US
Mailing Address - Phone:586-574-5080
Mailing Address - Fax:868-382-0425
Practice Address - Street 1:11900 E 12 MILE RD STE 308
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3491
Practice Address - Country:US
Practice Address - Phone:586-574-5080
Practice Address - Fax:868-382-0425
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087600207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1144424623Medicaid
MI0H208910OtherBLUE CROSS
MI0M71670Medicare PIN