Provider Demographics
NPI:1922346832
Name:FARIS Z HAKKI, M.D.
Entity Type:Organization
Organization Name:FARIS Z HAKKI, M.D.
Other - Org Name:HAKKI MEDICAL ASSOCIATION PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARIS
Authorized Official - Middle Name:Z
Authorized Official - Last Name:HAKKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-943-1646
Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:POB 408
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:301-943-1646
Mailing Address - Fax:410-721-6363
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:POB 408
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:301-943-1646
Practice Address - Fax:410-721-6363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD212912086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1437168325OtherINDIVIDUAL NPI
DC026637100Medicaid
DC792607Medicare PIN