Provider Demographics
NPI:1538229224
Name:HAWIT, SUHAIL IBRAHIM (MD)
Entity type:Individual
Prefix:DR
First Name:SUHAIL
Middle Name:IBRAHIM
Last Name:HAWIT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23521 PASEO DE VALENCIA STE 311
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3144
Mailing Address - Country:US
Mailing Address - Phone:949-305-2660
Mailing Address - Fax:949-305-2036
Practice Address - Street 1:23521 PASEO DE VALENCIA STE 311
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3144
Practice Address - Country:US
Practice Address - Phone:949-305-2660
Practice Address - Fax:949-305-2036
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC37808207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7102000CA92653OtherBLUE CROSS AND BLUE SHIELD OF MICHIGAN
MI7102000CA92653OtherBLUE CROSS AND BLUE SHIELD OF MICHIGAN
CAC37808Medicare PIN