Individual
HISHAM HATOUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Contact information
Practice address
1725 NEW HANOVER MEDICAL PARK DR, WILMINGTON, NC 28403-5345
(910) 662-9331
(910) 662-2403
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2021-00547
NC
208600000X
Surgery Physician
2021-00547
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2010
Last updated
07/07/2021
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