Provider Demographics
NPI:1720183528
Name:HADDAD, INAD (MD)
Entity Type:Individual
Prefix:DR
First Name:INAD
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 1:1548 W MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1382
Mailing Address - Country:US
Mailing Address - Phone:517-263-7577
Mailing Address - Fax:517-263-6643
Practice Address - Street 1:1548 W MAUMEE ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1382
Practice Address - Country:US
Practice Address - Phone:517-263-7577
Practice Address - Fax:517-263-6643
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301042940207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1733069Medicaid
MIA78229Medicare UPIN
MI0460012811Medicare ID - Type Unspecified