Provider Demographics
NPI:1215933221
Name:HAIDAK, DAVID J (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:HAIDAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8926 WOODYARD RD
Mailing Address - Street 2:STE 201
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4231
Mailing Address - Country:US
Mailing Address - Phone:301-868-7911
Mailing Address - Fax:301-868-2285
Practice Address - Street 1:8926 WOODYARD RD
Practice Address - Street 2:STE 201
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4231
Practice Address - Country:US
Practice Address - Phone:301-868-7911
Practice Address - Fax:301-868-2285
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2008-05-15
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Provider Licenses
StateLicense IDTaxonomies
MDD0017605207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC02810004OtherBC/BS OF DC
004052732OtherAETNA MNG
493216OtherHEALTHLINK
830001307OtherRR MEDICARE
830004072OtherRR MEDICARE
086401OtherCIGNA
3000017OtherUNITED HEALTHCARE
324510OtherMAMSI
481545OtherAETNA HMO
DCB6480002OtherBC/BS OF DC
DC022118900Medicaid
32300002OtherBC/BS OF MD - CLINTON
32300003OtherBC/BS OF MD - GREENBELT
324510OtherALLIANCE
058810OtherTRIGON
04701OtherAMERICAID
MD20096 1700Medicaid
3000017OtherUNITED HEALTHCARE
32300003OtherBC/BS OF MD - GREENBELT
DC058589O50Medicare PIN