Provider Demographics
NPI:1356790778
Name:HADDAD ABIAAD, TANIA (DO)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:HADDAD ABIAAD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:JIRIES
Other - Last Name:HADDAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9720 DIX
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1566
Mailing Address - Country:US
Mailing Address - Phone:313-841-1680
Mailing Address - Fax:313-841-3123
Practice Address - Street 1:9720 DIX
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1566
Practice Address - Country:US
Practice Address - Phone:313-841-1680
Practice Address - Fax:313-841-3123
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022868208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics