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1760487904

NPI Code Detail

MEDICARE: ROBERT GERGES HADDAD MD

MEDICARE: ROBERT GERGES 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	24152	AL
2	207R00000X	Internal Medicine Physician	28812	SC
3	207R00000X	Internal Medicine Physician	TL28812	SC
4	207R00000X	Internal Medicine Physician	39383	TN
5	207R00000X	Internal Medicine Physician	ME92754	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00734661	OTHER	SC	RAIL ROAD MEDICARE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7936430	OTHER	SC	AETNA
4	192321	OTHER	SC	MEDCOST
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760487904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT GERGES HADDAD MD

Provider Business Mailing Address
First Line	:	PO BOX 743070
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-3070
Country	:	US
Telephone Number	:	864-560-4304
Fax Number	:	864-560-4413

Provider Business Practice Location Address
First Line	:	101 E WOOD ST STE 401
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-3040
Country	:	US
Telephone Number	:	864-560-6654
Fax Number	:	864-560-7353

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	02/09/2023

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Directions to “ ROBERT GERGES HADDAD MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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