Provider Demographics
NPI:1366869380
Name:PYRAMID PHYSICIAN SERVICES LLC
Entity Type:Organization
Organization Name:PYRAMID PHYSICIAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMMAM
Authorized Official - Middle Name:HADI
Authorized Official - Last Name:AKBIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-705-1368
Mailing Address - Street 1:2680 INDIAN RIPPLE RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-3605
Mailing Address - Country:US
Mailing Address - Phone:937-705-1368
Mailing Address - Fax:937-298-5596
Practice Address - Street 1:2680 INDIAN RIPPLE RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-3605
Practice Address - Country:US
Practice Address - Phone:937-705-1368
Practice Address - Fax:937-298-5596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0104990Medicaid
OH0104990Medicaid