Provider Demographics
NPI:1740397918
Name:HAMZY, NADA J (MD)
Entity Type:Individual
Prefix:
First Name:NADA
Middle Name:J
Last Name:HAMZY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NADA
Other - Middle Name:ATEF
Other - Last Name:JUMBLAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:601 CLEMSON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-4341
Mailing Address - Country:US
Mailing Address - Phone:803-788-6146
Mailing Address - Fax:803-462-0312
Practice Address - Street 1:601 CLEMSON RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-4341
Practice Address - Country:US
Practice Address - Phone:803-788-6146
Practice Address - Fax:803-462-0312
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19366208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC193668Medicaid
SC193668Medicaid