Provider Demographics
NPI:1205664497
Name:HAGE, FADI (MD)
Entity type:Individual
Prefix:DR
First Name:FADI
Middle Name:
Last Name:HAGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4421 DRIFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1783
Mailing Address - Country:US
Mailing Address - Phone:519-694-9994
Mailing Address - Fax:
Practice Address - Street 1:LANKENAU HEART INSTITUTE
Practice Address - Street 2:100 EAST LANCASTER AVENUE, MOB EAST, SUITE 356
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096
Practice Address - Country:US
Practice Address - Phone:519-694-9994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD483773208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)