MEDICARE: SAFAA AL-HADDAD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35072830	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174746424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAFAA AL-HADDAD MD

Provider Business Mailing Address
First Line	:	PO BOX 901543
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44190-1543
Country	:	US
Telephone Number	:	440-250-2070
Fax Number	:	440-331-4063

Provider Business Practice Location Address
First Line	:	20575 CENTER RIDGE RD STE 500
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-3422
Country	:	US
Telephone Number	:	440-250-2070
Fax Number	:	440-331-4063

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	10/30/2008

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