Provider Demographics
NPI:1740203199
Name:BARMADA, HAZEM (MD, FRCS)
Entity Type:Individual
Prefix:MR
First Name:HAZEM
Middle Name:
Last Name:BARMADA
Suffix:
Gender:M
Credentials:MD, FRCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39566-0568
Mailing Address - Country:US
Mailing Address - Phone:228-875-0885
Mailing Address - Fax:228-875-8819
Practice Address - Street 1:1155 OCEAN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3421
Practice Address - Country:US
Practice Address - Phone:228-875-0885
Practice Address - Fax:228-875-8819
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16903208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00122968Medicaid
MS00122968Medicaid