MEDICARE: SAADEDDINE HIJAZI M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD020040-E	PA

General Provider Information

NPI Number	:	1740232826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAADEDDINE HIJAZI M.D

Provider Business Mailing Address
First Line	:	231 NORTHERN BLVD
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-9189
Country	:	US
Telephone Number	:	570-585-8085
Fax Number	:	570-585-8083

Provider Business Practice Location Address
First Line	:	231 NORTHERN BLVD
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-9189
Country	:	US
Telephone Number	:	570-585-8085
Fax Number	:	570-585-8083

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	07/08/2007

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