Provider Demographics
NPI:1528283231
Name:HADDER, WILLIAM S
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:HADDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:HARBESON
Mailing Address - State:DE
Mailing Address - Zip Code:19951-0206
Mailing Address - Country:US
Mailing Address - Phone:302-644-1810
Mailing Address - Fax:
Practice Address - Street 1:16529 COASTAL HWY
Practice Address - Street 2:RED MILL CENTER
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-3605
Practice Address - Country:US
Practice Address - Phone:302-644-1810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0001147225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist