Individual
HAITHAM I HADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
(216) 286-6341
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35-064239
OH
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
35-064239
OH
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
35-064239
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000183561
ANTHEM
OH
01
—
000000218707
UNISON
OH
01
—
000000526060
ANTHEM
OH
01
—
0207627
BCMH
OH
05
—
0207627
—
OH
01
—
1017568700001
PA MEDICAID
PA
05
—
1017568700001
—
PA
01
—
2126559
AETNA
OH
01
—
363601
WELLCARE
OH
01
—
728344
BUCKEYE
OH
Enumeration date
07/20/2006
Last updated
07/06/2011
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