Provider Demographics
NPI:1427255561
Name:AHMAD T. HAQ, M.D., P.C.
Entity type:Organization
Organization Name:AHMAD T. HAQ, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-634-5311
Mailing Address - Street 1:26 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-2802
Mailing Address - Country:US
Mailing Address - Phone:276-634-5311
Mailing Address - Fax:276-634-5312
Practice Address - Street 1:26 BROAD ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2802
Practice Address - Country:US
Practice Address - Phone:276-634-5311
Practice Address - Fax:276-634-5312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049557174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06420Medicare PIN