Individual
FARIS HADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4420
(703) 698-4444
(703) 204-0116
Mailing address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4420
(703) 698-4444
(703) 204-0116
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101251648
VA
2085R0202X
Diagnostic Radiology Physician
MD037929
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538463724
—
VA
01
—
316913
KAISER PERMANENTE
VA
05
—
3810023748
—
WV
Enumeration date
01/02/2011
Last updated
10/11/2012
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