Individual
BASSAM E HADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2076 WOODRUFF RD, GREENVILLE, SC 29607-5939
(864) 373-7246
Mailing address
1120 SPARKLEBERRY LANE EXT STE A, COLUMBIA, SC 29223-7078
(803) 851-0605
(866) 291-3617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31026
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31026
MED LICENSE
SC
05
—
PG1133
—
SC
Enumeration date
07/18/2008
Last updated
02/01/2024
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