Provider Demographics
NPI:1184654808
Name:HASHIM, MARK NADEEM (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:NADEEM
Last Name:HASHIM
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 1:7412 COMMUNITY CT
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7101
Mailing Address - Country:US
Mailing Address - Phone:828-339-7253
Mailing Address - Fax:828-586-8209
Practice Address - Street 1:7412 COMMUNITY CT
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7101
Practice Address - Country:US
Practice Address - Phone:727-861-1000
Practice Address - Fax:727-674-0570
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 74355207LP2900X, 208VP0014X
FLME74355208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271726OtherAVMED VENDOR ID
FL44963OtherBCBS PROV ID
FL255677400Medicaid
FLE0845AMedicare PIN
FL255677400Medicaid