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General NPI Number Information
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NPI Number | 1306133780
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Entity Type | Individual
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Provider Name | HAYDAR M AL-EID M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 1348 S 18TH ST STE 210
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-4785
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Country | US
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Telephone | 904-261-9108
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Fax | 904-261-9911
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Provider Business Mailing Address
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Address Line | PO BOX 746641
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City | ATLANTA
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State | GA
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Zip | 30374-6641
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Country | US
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Telephone | 904-202-2092
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Fax | 904-376-4075
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME170879
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 0101255173
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME170879
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101255173
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | ME170879
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 0101255173
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License Number State | VA
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