Provider Demographics
NPI:1609839133
Name:HADDAD, LABIB F (MD)
Entity Type:Individual
Prefix:DR
First Name:LABIB
Middle Name:F
Last Name:HADDAD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11475 OLDE CABIN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7128
Mailing Address - Country:US
Mailing Address - Phone:314-991-8200
Mailing Address - Fax:314-991-8206
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:DEPT OF RADIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-6031
Practice Address - Fax:314-251-6343
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2023-11-20
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Provider Licenses
StateLicense IDTaxonomies
MO1032632085R0202X, 2085R0204X
IN01074703A2085R0202X
ARE90112085R0202X
IL0360984172085R0202X
OK309812085R0202X
HIMD178992085R0202X
KS04376512085R0202X
CODR.00706102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK201198990AMedicaid
MO204018519Medicaid
MO038010769Medicare PIN
MO204018519Medicaid