Provider Demographics
NPI:1962443317
Name:ONCOLOGY-HEMATOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:ONCOLOGY-HEMATOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAIDAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-868-7911
Mailing Address - Street 1:8926 WOODYARD RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4220
Mailing Address - Country:US
Mailing Address - Phone:301-868-7911
Mailing Address - Fax:301-868-2285
Practice Address - Street 1:8926 WOODYARD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4220
Practice Address - Country:US
Practice Address - Phone:301-868-7911
Practice Address - Fax:301-868-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS237ONOtherBC/BS OF MD
596635OtherAETNA HMO
6062354OtherTRIGON
MDM338OtherAMERICAID
MD25410MD2OtherALLIANCE
CE1101OtherRR MEDICARE
DC022118900Medicaid
DC0281OtherBC/BS DC
1399476OtherUNITED HEALTHCARE
MD96907 1900Medicaid
25410MD2OtherMAMSI
596635OtherAETNA HMO