Individual
DR. KENNETH S HAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6600 W BROAD ST STE 300, RICHMOND, VA 23230-1709
(804) 320-4243
(804) 622-0552
Mailing address
1000 BOULDERS PKWY, SUITE 102, RICHMOND, VA 23225-5545
(804) 320-4243
(804) 622-0552
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0101054682
VA
207RP1001X
Pulmonary Disease Physician
Primary
0101054682
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005844690
—
VA
01
—
006895400
BLACK LUNG
VA
01
—
026890
CIGNA PROVIDER NUMBER
VA
01
—
127875
SOUTHERN HEALTH
VA
01
—
188463
ANTHEM PROVIDER NUMBER
VA
01
—
21031
CARENET
VA
01
—
4800275
UNITED HEALTHCAREE
VA
01
—
7101232
MAMSI PROVIDER NUMBER
VA
Enumeration date
07/14/2006
Last updated
05/19/2021
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