Organization
LIBERTY WELLCARE, PLLC
Active
Organization
LIBERTY WELLCARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMAD A HADDAD MD (CEO)
(859) 238-7756
Entity
Organization
Contact information
Practice address
216 BLUFFWOOD DR, DANVILLE, KY 40422-9788
(859) 238-7756
(270) 378-5786
Mailing address
216 BLUFFWOOD DR, DANVILLE, KY 40422-9788
(859) 238-7756
(270) 378-5786
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37821
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64065865
—
KY
Enumeration date
04/22/2013
Last updated
04/22/2013
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