Provider Demographics
NPI:1528128865
Name:AKIKI, HANNA TANIOS (MD)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:TANIOS
Last Name:AKIKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 PROFESSIONAL PKWY
Mailing Address - Street 2:SUITE 2080
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-5631
Mailing Address - Country:US
Mailing Address - Phone:770-424-6893
Mailing Address - Fax:770-528-9925
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 350
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-424-6893
Practice Address - Fax:770-528-9938
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA56670207R00000X
GA056670207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA928632824SMedicaid
GA928632824TMedicaid
GA928632824UMedicaid
GA928632824VMedicaid
GA928632824UMedicaid
GA928632824RMedicaid
GA928632824OMedicaid
GA06BDHZGMedicare ID - Type Unspecified
GA928632824QMedicaid