Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | MD073567L | PA |
Y | 207RI0011X | Interventional Cardiology | MD073567L | PA |
NPI | 1023045523 |
---|---|
Provider Name | Samir A Hadeed |
First Address | Johnstown, PA 15904-3221 |
Second Address | Johnstown, PA 15904-3221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 19/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0019514600004 | (05) | PA |
H09760 | (02) | PA |