Individual
DR. SOUHA S HAKIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1418 E MICHIGAN AVE, JACKSON, MI 49202-3518
(517) 783-1779
(517) 783-1899
Mailing address
1418 E MICHIGAN AVE, JACKSON, MI 49202-3518
(517) 783-1779
(517) 783-1899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301068721
MI
2080A0000X
Pediatric Adolescent Medicine Physician
4301068721
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03810061
BLUE CROSS BLUE SHIELD
MI
05
—
1044997-10
—
MI
Enumeration date
07/25/2006
Last updated
01/18/2021
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