Provider Demographics
NPI:1902844848
Name:HADDADIN, RAMZI (MD)
Entity Type:Individual
Prefix:
First Name:RAMZI
Middle Name:
Last Name:HADDADIN
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 1:2401 S KANAWHA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-6967
Mailing Address - Country:US
Mailing Address - Phone:304-255-6300
Mailing Address - Fax:304-255-6301
Practice Address - Street 1:2401 S KANAWHA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-6967
Practice Address - Country:US
Practice Address - Phone:304-255-6301
Practice Address - Fax:304-255-6301
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20964207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2003560000Medicaid
WVHA4100181Medicare PIN
H77860Medicare UPIN
WV2003560000Medicaid