Provider Demographics
NPI:1598851768
Name:ABDUL-HAKEEM, FATIMA FATIHA (MD)
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:FATIHA
Last Name:ABDUL-HAKEEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3958
Mailing Address - Country:US
Mailing Address - Phone:610-619-8590
Mailing Address - Fax:610-619-8591
Practice Address - Street 1:30 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013-3958
Practice Address - Country:US
Practice Address - Phone:610-619-8590
Practice Address - Fax:610-619-8591
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429199207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017410450001Medicaid
PA1017410450002Medicaid
PA1017410450003Medicaid
PA2862398000OtherBCBS - PA
PA2088899OtherHIGHMARK BLUE SHIELD
PA1017410450002Medicaid