Provider Demographics
NPI:1629760186
Name:HADDAD, EMAD (DPT)
Entity Type:Individual
Prefix:DR
First Name:EMAD
Middle Name:
Last Name:HADDAD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1904
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-1904
Mailing Address - Country:US
Mailing Address - Phone:706-701-3038
Mailing Address - Fax:
Practice Address - Street 1:4195 S LEE ST
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8019
Practice Address - Country:US
Practice Address - Phone:770-932-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist