Provider Demographics
NPI:1366442097
Name:SAADAT, MOHAMMAD JAVAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:JAVAD
Last Name:SAADAT
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 1:105 W CHURCH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2251
Mailing Address - Country:US
Mailing Address - Phone:814-445-5099
Mailing Address - Fax:814-444-1852
Practice Address - Street 1:105 W CHURCH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2251
Practice Address - Country:US
Practice Address - Phone:814-445-5099
Practice Address - Fax:814-444-1852
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2016-11-09
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
PAMD047643L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014447360006Medicaid
PA210882OtherUPMC HEALTH PLAN
PA1040153OtherGATEWAY HEALTH PLAN
252306OtherMAMSI
2098475OtherAETNA HMO
36290OtherHEALTH AMERICA
PA92816OtherTHREE RIVERS HEALTH PLAN
4662657OtherAETNA PPO
PA1040153OtherGATEWAY HEALTH PLAN
PA0014447360006Medicaid
PA0014447360006Medicaid