Provider Demographics
NPI:1518680545
Name:HADDOCK, ABIGAIL (PA-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HADDOCK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 CONNECTICUT AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5829
Mailing Address - Country:US
Mailing Address - Phone:301-304-8800
Mailing Address - Fax:
Practice Address - Street 1:8401 CONNECTICUT AVE STE 220
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5829
Practice Address - Country:US
Practice Address - Phone:301-304-8800
Practice Address - Fax:301-652-4933
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
MDC0009448363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant