Provider Demographics
NPI:1245419555
Name:VELAYUDHAN SAHADEVAN M D PH D
Entity Type:Organization
Organization Name:VELAYUDHAN SAHADEVAN M D PH D
Other - Org Name:DAG HAMMARSKJOLD CANCER TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D., PH. D.
Authorized Official - Prefix:DR
Authorized Official - First Name:VELAYUDHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHADEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-399-9298
Mailing Address - Street 1:PO BOX 5476
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801
Mailing Address - Country:US
Mailing Address - Phone:312-399-9298
Mailing Address - Fax:312-399-9298
Practice Address - Street 1:155 DRY HILL ROAD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:312-399-9298
Practice Address - Fax:312-399-9298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV13738291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory