Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | C2-0007933 | DE |
Y | 2086S0129X | Vascular Surgeon | OP00001319 | WA |
NPI | 1033298526 |
---|---|
Provider Name | Dr. Joseph A Haydu JR. |
First Address | Woodstock, VA 22664-2953 |
Second Address | Woodstock, VA 22664-2953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 31/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1000039731 | (05) | DE |
F06626 | (02) | DE |