Provider Demographics
NPI:1275528515
Name:HAFFAR, M YASER (MD)
Entity Type:Individual
Prefix:DR
First Name:M
Middle Name:YASER
Last Name:HAFFAR
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 1:1211 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-8707
Mailing Address - Country:US
Mailing Address - Phone:304-757-4694
Mailing Address - Fax:304-757-4695
Practice Address - Street 1:1211 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-8707
Practice Address - Country:US
Practice Address - Phone:304-757-4694
Practice Address - Fax:304-757-4695
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16209207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0073015000Medicaid
0819852Medicare ID - Type Unspecified
WV0073015000Medicaid