Provider Demographics
NPI:1962817635
Name:HADDAD, RAAD (MD)
Entity Type:Individual
Prefix:
First Name:RAAD
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 1:911 S 9TH ST STE 600
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3904
Mailing Address - Country:US
Mailing Address - Phone:215-955-4962
Mailing Address - Fax:215-928-3160
Practice Address - Street 1:911 S 9TH ST STE 600
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3904
Practice Address - Country:US
Practice Address - Phone:215-955-4962
Practice Address - Fax:215-928-3160
Is Sole Proprietor?:No
Enumeration Date:2014-06-21
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD481272207RE0101X
MI4301104945390200000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program