Provider Demographics
NPI:1659458156
Name:SAADLLA, HAVAL (MD)
Entity Type:Individual
Prefix:DR
First Name:HAVAL
Middle Name:
Last Name:SAADLLA
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 1:4439 STATE ROUTE 159 STE 210
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8207
Mailing Address - Country:US
Mailing Address - Phone:740-779-8700
Mailing Address - Fax:740-779-8709
Practice Address - Street 1:4439 STATE ROUTE 159 STE 210
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8207
Practice Address - Country:US
Practice Address - Phone:740-779-8700
Practice Address - Fax:740-779-8709
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.094173207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409060800Medicaid
DC037304800Medicaid
OH2973680Medicaid
MD415096100Medicaid
MD64882401OtherBCBS MARYLAND
DCJ0950016OtherBCBS DC
I47444Medicare UPIN
DC135580Medicare PIN
OH2973680Medicaid
MD018624C82Medicare ID - Type Unspecified