Provider Demographics
NPI:1154503738
Name:AL HNAWI, HAZEM (MD)
Entity Type:Individual
Prefix:
First Name:HAZEM
Middle Name:
Last Name:AL HNAWI
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 1:8163 ALPINE ASTER CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-1904
Mailing Address - Country:US
Mailing Address - Phone:864-353-9702
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE # ML5021
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-803-8092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43929174400000X
IN01066317A174400000X
FLME153919208000000X
OH35.096866208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0103234Medicaid
IN200959270Medicaid