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General NPI Number Information
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NPI Number | 1740972678
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Entity Type | Individual
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Provider Name | HAIDAR ALWAELI MD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 200 SCHUYLKILL MEDICAL PLZ
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City | POTTSVILLE
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State | PA
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Zip | 17901-3660
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Country | US
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Telephone | 570-621-9270
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Fax |
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Provider Business Mailing Address
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Address Line | 344 DOCK ST UNIT 2
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City | SCHUYLKILL HAVEN
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State | PA
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Zip | 17972-1212
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Country | US
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Telephone | 623-332-5719
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD491543
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT228151
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License Number State | PA
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