Provider Demographics
NPI:1932113446
Name:HAKIM, FAIYAZ H (MD)
Entity Type:Individual
Prefix:DR
First Name:FAIYAZ
Middle Name:H
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 1:290 TURNPIKE RD STE 150-414
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2843
Mailing Address - Country:US
Mailing Address - Phone:508-753-4151
Mailing Address - Fax:508-751-1974
Practice Address - Street 1:290 TURNPIKE RD STE 150-414
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2843
Practice Address - Country:US
Practice Address - Phone:508-753-4151
Practice Address - Fax:508-751-1974
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75082207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3090922Medicaid
Y02757Medicare ID - Type Unspecified
E73555Medicare UPIN