MEDICARE: DARLA J HADDEN PA-C

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	363A00000X	Physician Assistant	50.002205	OH

General Provider Information

NPI Number	:	1417976960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLA J HADDEN PA-C

Provider Business Mailing Address
First Line	:	26908 DETROIT RD STE 103
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-2399
Country	:	US
Telephone Number	:	440-249-0274
Fax Number	:	440-808-1718

Provider Business Practice Location Address
First Line	:	26908 DETROIT RD STE 103
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-2399
Country	:	US
Telephone Number	:	440-249-0274
Fax Number	:	440-808-1718

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/06/2020

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