Provider Demographics
NPI:1649224551
Name:HAKKI, FAWAZ ZAKAI (MD)
Entity Type:Individual
Prefix:
First Name:FAWAZ
Middle Name:ZAKAI
Last Name:HAKKI
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 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:501 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2353
Practice Address - Country:US
Practice Address - Phone:717-765-3648
Practice Address - Fax:717-765-3647
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429143207R00000X, 207RI0008X, 207RG0100X, 207RI0008X, 207R00000X
FLME91888207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25-1716306OtherINTERGROUP
PA50062744OtherCAPITAL BLUECROSS
PA7514222OtherAETNA NON-HMO
PAP00377937OtherRAILROAD MEDICARE
PA101713873 0002Medicaid
PA1559922OtherGATEWAY
PA2165768OtherMAMSI
PA25-1716306OtherDEVON
PA458610OtherHEALTH AMERICA
PA193600OtherUNISON
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA25-1716306OtherFIRST HEALTH
PA867633OtherMEDICARE GROUP #
PAG920-0064/KDM4CUOtherCAREFIRST
PA1373348OtherAETNA HMO
PA25-1716306OtherGREATWEST
PA25-1716306OtherMULTIPLAN/PHCS
PA25-1716306OtherINFORMED
PAHA1886704OtherHIGHMARK BLUE SHIELD
PA25-1716306OtherHEALTHNET/TRICARE
PAMD429143OtherLICENSE
PAMD429143OtherLICENSE
PAG920-0064/KDM4CUOtherCAREFIRST
PA104875LN7Medicare PIN