Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 29881 | GA |
Y | 208600000X | Surgeon | 29881 | GA |
NPI | 1003993817 |
---|---|
Provider Name | Dr. Akram Mahmoud Hassanyeh |
First Address | Statesboro, GA 30458-0858 |
Second Address | Statesboro, GA 30458-0858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 12/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000365131D | (05) | GA |
020046873 | RAILROAD MEDICARE (01) | GA |
10062642 | AMERIGROUP (01) | GA |
354445 | WELLCARE (01) | GA |
582449176 | CEDAR SURGICAL ASSOCIATES (01) | GA |
C64824 | (02) | GA |