Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 0101247463 | VA |
N | 207RC0000X | Internist - Cardiovascular Disease | MD419248 | PA |
NPI | 1033105408 |
---|---|
Provider Name | Agha W Haider |
First Address | Richmond, VA 23225-4038 |
Second Address | Richmond, VA 23225-4038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 26/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013280500001 | (05) | PA |
1033105408 | (05) | VA |
I36914 | (02) | PA |
P00863900 | MEDICARE RAILROAD (01) | VA |
VAA102350 | MEDICARE (01) | VA |