Provider Demographics
NPI:1730265695
Name:HAIDAR, WAEL (MD)
Entity type:Individual
Prefix:
First Name:WAEL
Middle Name:
Last Name:HAIDAR
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 1:625 AFRICA RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9814
Mailing Address - Country:US
Mailing Address - Phone:614-508-0110
Mailing Address - Fax:614-508-0109
Practice Address - Street 1:625 AFRICA RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9814
Practice Address - Country:US
Practice Address - Phone:614-508-0110
Practice Address - Fax:614-508-0109
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.121782207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0087729Medicaid
OH0087729Medicaid
MI4938088Medicaid
MIP26070007Medicare PIN