Provider Demographics
NPI:1508064270
Name:ALHATEM, EID (MD)
Entity Type:Individual
Prefix:
First Name:EID
Middle Name:
Last Name:ALHATEM
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 1:425 HOME ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-1407
Mailing Address - Country:US
Mailing Address - Phone:937-378-7515
Mailing Address - Fax:937-378-7513
Practice Address - Street 1:425 HOME ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-1407
Practice Address - Country:US
Practice Address - Phone:937-378-7515
Practice Address - Fax:937-378-7513
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-094874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine