Provider Demographics
NPI:1851399919
Name:HAKIM, PAUL (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:HAKIM
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 1:26850 PROVIDENCE PARKWAY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374
Mailing Address - Country:US
Mailing Address - Phone:248-662-4388
Mailing Address - Fax:248-662-4383
Practice Address - Street 1:26850 PROVIDENCE PARKWAY
Practice Address - Street 2:SUITE 500
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374
Practice Address - Country:US
Practice Address - Phone:248-662-4388
Practice Address - Fax:248-662-4383
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070736207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI432027810Medicaid
MI0F36022086Medicare ID - Type Unspecified
MI432027810Medicaid