Provider Demographics
NPI:1720042039
Name:NAJJAR, SAKIB M (M D)
Entity Type:Individual
Prefix:
First Name:SAKIB
Middle Name:M
Last Name:NAJJAR
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 SOUTHVIEW DR
Mailing Address - Street 2:P. O. BOX 1190
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-4317
Mailing Address - Country:US
Mailing Address - Phone:304-327-2907
Mailing Address - Fax:304-327-2989
Practice Address - Street 1:1331 SOUTHVIEW DR
Practice Address - Street 2:SUITE 3
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-4320
Practice Address - Country:US
Practice Address - Phone:304-325-8171
Practice Address - Fax:304-325-3914
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17140207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0075276000Medicaid
D67488Medicare UPIN
WV7331411Medicare ID - Type Unspecified