Provider Demographics
NPI:1427363860
Name:JOSEPH B HADDAD MD FACOG PC
Entity Type:Organization
Organization Name:JOSEPH B HADDAD MD FACOG PC
Other - Org Name:JOSEPH B HADDAD MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BENNY
Authorized Official - Last Name:HADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-285-7523
Mailing Address - Street 1:5901 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2538
Mailing Address - Country:US
Mailing Address - Phone:804-285-7523
Mailing Address - Fax:804-282-1433
Practice Address - Street 1:5901 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2538
Practice Address - Country:US
Practice Address - Phone:804-285-7523
Practice Address - Fax:804-282-1433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101026386207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006201920Medicaid
VA006201920Medicaid