Individual
JAMAL A. HADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5462
(740) 446-5082
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5462
(740) 446-5082
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
1897
WV
207V00000X
Obstetrics & Gynecology Physician
Primary
34-00-7309
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000181640
UNISON MEDICAID
OH
01
—
000000196977
ANTHEM BCBS
—
01
—
001714114
MOUNTAIN STATE BCBS
—
01
—
160046432
RR MEDICARE
—
01
—
2153593
MOLINA MEDICAID
OH
05
—
2153593
—
OH
01
—
310917085061
CARESOURCE MEDICAID
OH
05
—
6200106000
—
WV
05
—
64043706
—
KY
Enumeration date
05/31/2006
Last updated
11/28/2012
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