Basic Information
| Provider Information | |||||||||
| NPI: | 1285634600 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMAD | ||||||||
| FirstName: | SABAH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 107 MONARCH WAY | ||||||||
| Address2: | |||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275118975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198542929 | ||||||||
| FaxNumber: | 9198519223 | ||||||||
| Practice Location | |||||||||
| Address1: | 530 NEW WAVERLY PL | ||||||||
| Address2: | STE. 304 | ||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275187414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198519193 | ||||||||
| FaxNumber: | 9198519223 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2005 | ||||||||
| LastUpdateDate: | 08/13/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 200000223 | NC | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 016W6 | 01 | NC | BC/BS GROUP ID # | OTHER | 1253M | 01 | NC | BC/BS INDIVIDUAL ID# | OTHER | 5900017 | 05 | NC | MEDICAID | 891253M | 05 | NC | MEDICAID | 2000-00223 | 01 | NC | NC MEDICAL LICENSE # | OTHER | 5082560 | 01 | NC | AETNA PROVIDER # | OTHER | 8722516 | 01 | NC | CIGNA PROVIDER # | OTHER |