Provider Demographics
NPI:1609850007
Name:HADDAD, JAMES D (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:HADDAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:300 STAFFORD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3581
Mailing Address - Country:US
Mailing Address - Phone:413-748-7095
Mailing Address - Fax:413-733-5604
Practice Address - Street 1:2 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 410
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1270
Practice Address - Country:US
Practice Address - Phone:413-748-7095
Practice Address - Fax:413-732-0225
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA57681207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3023699Medicaid
MAB77240Medicare UPIN
MAJ06170Medicare ID - Type Unspecified
MAJ06170Medicare PIN