Provider Demographics
NPI:1740257906
Name:HAMO, WAEL (MD)
Entity type:Individual
Prefix:DR
First Name:WAEL
Middle Name:
Last Name:HAMO
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 1:1263 TALLADEGA HWY
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-1604
Mailing Address - Country:US
Mailing Address - Phone:256-249-0091
Mailing Address - Fax:256-249-0024
Practice Address - Street 1:1263 TALLADEGA HWY
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-1604
Practice Address - Country:US
Practice Address - Phone:256-249-0091
Practice Address - Fax:256-249-0024
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL190112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529908170Medicaid
051500124Medicare ID - Type Unspecified
AL529908170Medicaid