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Individual

CHARLES HADDAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 727-7096
(505) 727-7099
Mailing address
4101 INDIAN SCHOOL RD NE STE 110, ALBUQUERQUE, NM 87110-3991
(505) 727-7096
(505) 727-7099

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18896
AZ
208600000X
Surgery Physician
Primary
MD2013-0238
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171421
AZ
05
63828847
NM
Enumeration date
01/17/2006
Last updated
03/26/2020
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