Provider Demographics
NPI:1821038886
Name:HADDAD, BASEM (MD)
Entity Type:Individual
Prefix:
First Name:BASEM
Middle Name:
Last Name:HADDAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:24651 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5635
Mailing Address - Country:US
Mailing Address - Phone:440-895-5056
Mailing Address - Fax:440-333-2935
Practice Address - Street 1:25200 CENTER RIDGE RD
Practice Address - Street 2:SUITE 3400
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4141
Practice Address - Country:US
Practice Address - Phone:440-331-4646
Practice Address - Fax:440-331-3197
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-04-27
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Provider Licenses
StateLicense IDTaxonomies
OH35075747H207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
3610861OtherGROUP ASC MEDICARE
0119204OtherGROUP MEDICAID
OH2149955Medicaid
9273172OtherGROUP MEDICARE
11610625OtherCAQH
P00353021OtherRR MEDICARE INDIVIDUAL
106463OtherKAISER
1780634279OtherGROUP NPI
CA4511OtherGROUP RR MEDICARE
D368301OtherGROUP IND DIAGNOSTICS MED
9273172OtherGROUP MEDICARE
11610625OtherCAQH
9273172OtherGROUP MEDICARE