Provider Demographics
NPI:1497967426
Name:HAIDER, SYED ADNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:ADNAN
Last Name:HAIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1050 WALL ST W
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-3621
Mailing Address - Country:US
Mailing Address - Phone:201-821-7900
Mailing Address - Fax:201-555-0550
Practice Address - Street 1:324 STEVENS ENTRY
Practice Address - Street 2:SUITE C
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1325
Practice Address - Country:US
Practice Address - Phone:770-542-7636
Practice Address - Fax:678-489-5597
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-114295207L00000X
GA61084208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology