Provider Demographics
NPI:1952391716
Name:ALKAIED, HOMAM (MD)
Entity Type:Individual
Prefix:
First Name:HOMAM
Middle Name:
Last Name:ALKAIED
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 1:1001 E SUPERIOR ST
Mailing Address - Street 2:STE. L101
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2207
Mailing Address - Country:US
Mailing Address - Phone:218-249-3081
Mailing Address - Fax:218-249-7875
Practice Address - Street 1:1001 E SUPERIOR ST
Practice Address - Street 2:STE. L101
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2207
Practice Address - Country:US
Practice Address - Phone:218-249-3081
Practice Address - Fax:218-249-7875
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN55849207R00000X, 207RH0000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02571662Medicaid
P3244239OtherOXFORD
2409346OtherUHC
2514151OtherGHI
3342N2OtherEMPIRE BC/BS
P3244239OtherOXFORD
P3244239OtherOXFORD