MEDICARE: DAVID S HADEN MD PC

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

General Provider Information

NPI Number	:	1063722510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID S HADEN MD PC

Provider Business Mailing Address
First Line	:	5505 INDIAN RIVER RD STE 101
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-5252
Country	:	US
Telephone Number	:	757-420-9573
Fax Number	:	757-420-5649

Provider Business Practice Location Address
First Line	:	5505 INDIAN RIVER RD STE 101
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-5252
Country	:	US
Telephone Number	:	757-420-9573
Fax Number	:	757-420-5649

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID HADEN
Credential	:	M.D.
Telephone Number	:	757-420-9573

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	10/21/2010

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