Provider Demographics
NPI:1518978428
Name:HADDAD, JOSEPH BENNY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BENNY
Last Name:HADDAD
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 1:5901 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
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101026386207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006201920Medicaid
VA006201920Medicaid
VAA102429Medicare PIN