Provider Demographics
NPI:1518270636
Name:HAJI, MADIHA DAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MADIHA
Middle Name:DAR
Last Name:HAJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MADIHA
Other - Middle Name:
Other - Last Name:DAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7957 COUNTRY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2770
Mailing Address - Country:US
Mailing Address - Phone:616-617-3618
Mailing Address - Fax:
Practice Address - Street 1:7957 COUNTRY LAKE DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-2770
Practice Address - Country:US
Practice Address - Phone:901-512-4167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-18
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN56848207Q00000X
MS22821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine