Provider Demographics
NPI:1972529717
Name:HAFT, KENNETH S (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:S
Last Name:HAFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1000 BOULDERS PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5545
Mailing Address - Country:US
Mailing Address - Phone:804-320-4243
Mailing Address - Fax:804-622-0552
Practice Address - Street 1:6600 W BROAD ST STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1709
Practice Address - Country:US
Practice Address - Phone:804-320-4243
Practice Address - Fax:804-622-0552
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054682207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005844690Medicaid
VA188463OtherANTHEM PROVIDER NUMBER
VA21031OtherCARENET
VA127875OtherSOUTHERN HEALTH
VA4800275OtherUNITED HEALTHCAREE
VA026890OtherCIGNA PROVIDER NUMBER
VA006895400OtherBLACK LUNG
VA188463OtherANTHEM HEALTHKEEPERS
VA7101232OtherMAMSI PROVIDER NUMBER
VA006895400OtherBLACK LUNG
VA188463OtherANTHEM PROVIDER NUMBER