Provider Demographics
NPI:1528037033
Name:HADDAD, SINAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SINAN
Middle Name:
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 1:1630 PLEASANT HILL RD STE 340
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5829
Mailing Address - Country:US
Mailing Address - Phone:678-680-4290
Mailing Address - Fax:678-680-4295
Practice Address - Street 1:1630 PLEASANT HILL RD STE 340
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5829
Practice Address - Country:US
Practice Address - Phone:678-680-4290
Practice Address - Fax:678-680-4295
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA355208OtherWELLCARE
GA839618790AOtherAMERIGROUP
GA839618790AMedicaid
GA904302OtherBLUE CROSS BLUE SHIELD
GA355208OtherWELLCARE
GA839618790AOtherAMERIGROUP
GA839618790AMedicaid