Provider Demographics
NPI:1841590593
Name:HAKIM MEDICAL ENTERPRISES, P.A.
Entity Type:Organization
Organization Name:HAKIM MEDICAL ENTERPRISES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:AIMAN
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:952-476-2065
Mailing Address - Street 1:2963 FAIRCHILD AVE
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-2956
Mailing Address - Country:US
Mailing Address - Phone:952-476-2065
Mailing Address - Fax:952-476-7693
Practice Address - Street 1:2963 FAIRCHILD AVE
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-2956
Practice Address - Country:US
Practice Address - Phone:952-476-2065
Practice Address - Fax:952-476-7693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN177208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty