Provider Demographics
NPI:1386613347
Name:HAGOS, HADDIS (MD)
Entity type:Individual
Prefix:DR
First Name:HADDIS
Middle Name:
Last Name:HAGOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7300 HANOVER DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2202
Mailing Address - Country:US
Mailing Address - Phone:301-220-2333
Mailing Address - Fax:301-220-2339
Practice Address - Street 1:7300 HANOVER DR
Practice Address - Street 2:SUITE 204
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2202
Practice Address - Country:US
Practice Address - Phone:301-220-2333
Practice Address - Fax:301-220-2339
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0059481207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology