Provider Demographics
NPI:1689697625
Name:HAJJAR, MARTIN M (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:M
Last Name:HAJJAR
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 1:1530 US HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-5056
Mailing Address - Country:US
Mailing Address - Phone:205-487-7000
Mailing Address - Fax:205-487-7666
Practice Address - Street 1:1530 US HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5056
Practice Address - Country:US
Practice Address - Phone:205-487-7000
Practice Address - Fax:205-487-7666
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067590207PE0004X
OH35067590H207Q00000X
AL29742207Q00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0997417Medicaid
OH0887172Medicare PIN
F93120Medicare UPIN