Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 35-064239 | OH |
Y | 2080P0203X | Pediatric Critical Care Doctor | 35-064239 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 35-064239 | OH |
NPI | 1215957345 |
---|---|
Provider Name | Haitham I Haddad |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 06/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000183561 | ANTHEM (01) | OH |
000000218707 | UNISON (01) | OH |
000000526060 | ANTHEM (01) | OH |
0207627 | (05) | OH |
0207627 | BCMH (01) | OH |
1017568700001 | (05) | PA |
1017568700001 | PA MEDICAID (01) | PA |
2126559 | AETNA (01) | OH |
363601 | WELLCARE (01) | OH |
728344 | BUCKEYE (01) | OH |
H35933 | (02) | OH |