Provider Demographics
NPI:1235172164
Name:HADDAD, ELIAS V (MD)
Entity Type:Individual
Prefix:
First Name:ELIAS
Middle Name:V
Last Name:HADDAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4230 HARDING PIKE
Mailing Address - Street 2:STE 330
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2018
Mailing Address - Country:US
Mailing Address - Phone:615-269-4545
Mailing Address - Fax:615-565-6748
Practice Address - Street 1:1215 21ST AVE S
Practice Address - Street 2:SUITE 5100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0014
Practice Address - Country:US
Practice Address - Phone:615-322-2318
Practice Address - Fax:615-875-6181
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN39630207R00000X, 207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3333478Medicaid
KY6411924100OtherKENTUCKY MEDICAID
7121802OtherAETNA
TN4141588OtherBLUE CROSS
P00395861OtherRAILROAD MEDICARE
TN4119774OtherBCBS
TN3333478Medicaid