Provider Demographics
NPI:1851580088
Name:HUDAIHED, ALHAKAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ALHAKAM
Middle Name:
Last Name:HUDAIHED
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 1:2507 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4424
Mailing Address - Country:US
Mailing Address - Phone:850-215-5911
Mailing Address - Fax:850-914-3004
Practice Address - Street 1:2507 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4424
Practice Address - Country:US
Practice Address - Phone:850-215-5911
Practice Address - Fax:850-914-3004
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201365207R00000X
FLME103502207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000888700Medicaid
FL000888700Medicaid