Organization
SURGICAL ASSOCIATES OF BLOOMINGTON, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FADI HADDAD MD (OWNER)
(812) 336-4707
Entity
Organization
Contact information
Practice address
822 W 1ST ST, SUITE 8, BLOOMINGTON, IN 47403-2384
(812) 336-4707
(812) 334-1093
Mailing address
822 W 1ST ST, SUITE 8, BLOOMINGTON, IN 47403-2384
(812) 336-4707
(812) 334-1093
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF0586
TRAVELERS MEDICARE
IN
Enumeration date
07/06/2006
Last updated
10/16/2007
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