Provider Demographics
NPI:1144482522
Name:HAMID, TARIQ (MBBS)
Entity type:Individual
Prefix:
First Name:TARIQ
Middle Name:
Last Name:HAMID
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 GEMMA DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-8116
Mailing Address - Country:US
Mailing Address - Phone:610-509-8739
Mailing Address - Fax:
Practice Address - Street 1:2820 SE 3RD CT STE 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0442
Practice Address - Country:US
Practice Address - Phone:352-401-8817
Practice Address - Fax:352-401-8822
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4302084N0400X
FLME01101742084N0400X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH32000708Medicaid
NH002261001Medicare PIN