Provider Demographics
NPI:1518077890
Name:JAVED CARDIAC CENTER, PLLC
Entity Type:Organization
Organization Name:JAVED CARDIAC CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:JAVED
Authorized Official - Last Name:RANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-322-0000
Mailing Address - Street 1:2003 LEATHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-2026
Mailing Address - Country:US
Mailing Address - Phone:276-322-0000
Mailing Address - Fax:276-322-0003
Practice Address - Street 1:2003 LEATHERWOOD LN
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-2026
Practice Address - Country:US
Practice Address - Phone:276-322-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055460174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010114918Medicaid
233-35-5598OtherSS# FOR MOHAMMAD RANA, MD
WV0080080000Medicaid
1679574644OtherINDIVIDUAL PROVIDER #
233-35-5598OtherSS# FOR MOHAMMAD RANA, MD
WV0080080000Medicaid
WV4013211Medicare PIN