Provider Demographics
NPI:1649252347
Name:HAGA, DAVID S (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:HAGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 OAKWOOD DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-3001
Mailing Address - Country:US
Mailing Address - Phone:434-846-8421
Mailing Address - Fax:434-846-2655
Practice Address - Street 1:118 OAKWOOD DR
Practice Address - Street 2:SUITE A
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-3001
Practice Address - Country:US
Practice Address - Phone:434-846-8421
Practice Address - Fax:434-846-2655
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101038310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005601720Medicaid
VA065970OtherANTHEM
VA080086433OtherMEDICARE RAILROAD
VA080086433OtherMEDICARE RAILROAD
VA015108C58Medicare PIN