Provider Demographics
NPI:1811924210
Name:HAIDER, NAEEM (MD)
Entity type:Individual
Prefix:
First Name:NAEEM
Middle Name:
Last Name:HAIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 UNIVERSITY BLVD S STE 6
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4346
Mailing Address - Country:US
Mailing Address - Phone:904-737-2722
Mailing Address - Fax:904-737-2723
Practice Address - Street 1:3599 UNIVERSITY BLVD SO
Practice Address - Street 2:SUITE 805
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-396-1380
Practice Address - Fax:904-396-3878
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0087986207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269445000Medicaid
G41315Medicare UPIN
FLU08102Medicare ID - Type Unspecified