Provider Demographics
NPI:1306133780
Name:AL-EID, HAYDAR M (MD)
Entity type:Individual
Prefix:DR
First Name:HAYDAR
Middle Name:M
Last Name:AL-EID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746641
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6641
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-376-4075
Practice Address - Street 1:1348 S 18TH ST STE 210
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-4785
Practice Address - Country:US
Practice Address - Phone:904-261-9108
Practice Address - Fax:904-261-9911
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2025-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME170879207R00000X, 207RP1001X, 207RC0200X
VA0101255173207RP1001X, 207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine