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Individual

MR. ERIC J HAACKE-GOLDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 HAYDENPARK LN STE 300, HENRICO, VA 23233-7867
(804) 998-1600
(804) 998-1601
Mailing address
3400 HAYDENPARK LN STE 300, HENRICO, VA 23233-7867
(804) 998-1600
(804) 323-1276

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101228662
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5640938
VA
01
C08279
MEDICARE PTAN
Enumeration date
09/30/2005
Last updated
04/23/2024
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