Individual
HAYTHAM FARUQ ADADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR STE 312D, ABINGDON, VA 24211-7664
(276) 258-1100
(276) 258-1745
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101251575
VA
207R00000X
Internal Medicine Physician
2009016606
MO
207R00000X
Internal Medicine Physician
46374
TN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0101251575
VA
207RP1001X
Pulmonary Disease Physician
Primary
0101251575
VA
207RP1001X
Pulmonary Disease Physician
46374
TN
390200000X
Student in an Organized Health Care Education/Training Program
MT187604
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11995962
CAQH ID
—
05
—
1336324896
—
MO
05
—
1336324896
—
NC
05
—
1336324896
—
VA
05
—
1521185
—
TN
01
—
431560263
TRICARE WEST
—
05
—
7100185780
—
KY
01
—
P00739159
RAILROAD MEDICARE
—
01
—
P00885378
RAILROAD MEDICARE
TN
Enumeration date
01/03/2008
Last updated
05/15/2024
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