Healthcare Provider Details

I. General information

NPI: 1013098870
Provider Name (Legal Business Name): JOSEPH M HAGGERTY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9707 MEDICAL CENTER DR SUITE 300
ROCKVILLE MD
20850-3348
US

IV. Provider business mailing address

9707 MEDICAL CENTER DR SUITE 300
ROCKVILLE MD
20850-3348
US

V. Phone/Fax

Practice location:
  • Phone: 301-424-6231
  • Fax: 301-294-4648
Mailing address:
  • Phone: 301-424-6231
  • Fax: 301-294-4648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD0032407
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: