Provider Demographics
NPI:1063722510
Name:DAVID S HADEN MD PC
Entity type:Organization
Organization Name:DAVID S HADEN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HADEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-420-9573
Mailing Address - Street 1:5505 INDIAN RIVER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5252
Mailing Address - Country:US
Mailing Address - Phone:757-420-9573
Mailing Address - Fax:757-420-5649
Practice Address - Street 1:5505 INDIAN RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-5252
Practice Address - Country:US
Practice Address - Phone:757-420-9573
Practice Address - Fax:757-420-5649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty