Provider Demographics
NPI:1124113022
Name:HADDAD, EDUARDO S (MD)
Entity type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:S
Last Name:HADDAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:35 UNITED DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1027
Mailing Address - Country:US
Mailing Address - Phone:508-238-8646
Mailing Address - Fax:
Practice Address - Street 1:575 TURNPIKE ST STE 17
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5937
Practice Address - Country:US
Practice Address - Phone:978-686-4343
Practice Address - Fax:978-682-5191
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46060207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2099594Medicaid
MA706045OtherTUFTS HEALTH CARE
MAB26244OtherBLUE CROSS
MA706045OtherTUFTS HEALTH CARE
B26244Medicare ID - Type Unspecified