Individual
AHMAD A HAIDAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 COUNTRY CLUB RD, CARRIERE, MS 39426-9037
(601) 799-4777
(601) 799-0052
Mailing address
200 COUNTRY CLUB RD, CARRIERE, MS 39426
(601) 799-4777
(601) 799-0052
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13678
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112453
—
MS
01
—
09520729
MEDICAID GROUP
MS
01
—
110240293
RAILROAD MEDICARE
MS
05
—
1658723
—
LA
01
—
302G709744
MEDICARE GROUP
MS
Enumeration date
11/07/2005
Last updated
02/07/2014
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