Individual
SERAG FARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 264-6000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32592
MS
208M00000X
Hospitalist Physician
Primary
32592
MS
Other
Enumeration date
04/12/2019
Last updated
01/02/2024
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