Provider Demographics
NPI:1881641439
Name:HAJO, NAWAR R (MD)
Entity Type:Individual
Prefix:DR
First Name:NAWAR
Middle Name:R
Last Name:HAJO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:110 PEMBROKE PT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31028-8011
Mailing Address - Country:US
Mailing Address - Phone:478-953-4326
Mailing Address - Fax:727-507-3618
Practice Address - Street 1:1601 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3431
Practice Address - Country:US
Practice Address - Phone:478-542-7830
Practice Address - Fax:478-542-7940
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA55055207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H97808Medicare UPIN