Provider Demographics
NPI:1245313949
Name:SAADO, WALID (MD)
Entity type:Individual
Prefix:
First Name:WALID
Middle Name:
Last Name:SAADO
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:PO BOX 1929
Mailing Address - Street 2:
Mailing Address - City:CLINTWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24228-1929
Mailing Address - Country:US
Mailing Address - Phone:276-926-5511
Mailing Address - Fax:276-926-5513
Practice Address - Street 1:5476 DICKENSON HWY
Practice Address - Street 2:
Practice Address - City:CLINTWOOD
Practice Address - State:VA
Practice Address - Zip Code:24228-7182
Practice Address - Country:US
Practice Address - Phone:276-926-5511
Practice Address - Fax:276-926-5513
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050942207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006099378Medicaid
VA006099378Medicaid
VA110006698Medicare PIN
VAF66910Medicare UPIN