MEDICARE: DR. GHASSAN FERRIS HADDAD MD

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	35079178	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00000021198	OTHER		ANTHEM
2	0007401303	OTHER		AETNA
3	25772	OTHER	OH	QUAL CHOICE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0407269	OTHER		UNITED HEALTH CARE

General Provider Information

NPI Number	:	1730286568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GHASSAN FERRIS HADDAD MD

Provider Business Mailing Address
First Line	:	24701 EUCLID AVE
Second Line	:	THIRD FLOOR - BILLING SERVICES
City	:	EUCLID
State	:	OH
Zip	:	44117-1714
Country	:	US
Telephone Number	:	440-232-4455
Fax Number	:	440-232-3147

Provider Business Practice Location Address
First Line	:	88 CENTER RD.
Second Line	:	SUITE 130
City	:	CLEVELAND
State	:	OH
Zip	:	44146
Country	:	US
Telephone Number	:	440-232-4455
Fax Number	:	440-232-3147

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	12/29/2020

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