Provider Demographics
NPI:1841785961
Name:HAKOUM, MARAM (MD)
Entity Type:Individual
Prefix:
First Name:MARAM
Middle Name:
Last Name:HAKOUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LOCUST AVE EXT
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:PA
Mailing Address - Zip Code:15349-1355
Mailing Address - Country:US
Mailing Address - Phone:724-324-9001
Mailing Address - Fax:724-324-9005
Practice Address - Street 1:120 LOCUST AVE EXT
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:PA
Practice Address - Zip Code:15349-1355
Practice Address - Country:US
Practice Address - Phone:724-324-9001
Practice Address - Fax:724-324-9005
Is Sole Proprietor?:No
Enumeration Date:2018-07-01
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT215559390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program