MEDICARE: TAOUFIK A. SADAT, MD

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	207W00000X	Ophthalmology Physician	20564	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DF1826	OTHER	WV	MEDICARE RAIL ROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770742199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAOUFIK A. SADAT, MD

Provider Business Mailing Address
First Line	:	PO BOX 172
Second Line	:
City	:	STANAFORD
State	:	WV
Zip	:	25927-0172
Country	:	US
Telephone Number	:	304-252-6274
Fax Number	:	304-252-6274

Provider Business Practice Location Address
First Line	:	22 MALLARD CT
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-3615
Country	:	US
Telephone Number	:	304-252-6274
Fax Number	:	304-252-6274

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TAOUFIK A SADAT
Credential	:	MD
Telephone Number	:	304-252-6274

Provider Enumeration Date	:	06/02/2008
Last Update Date	:	06/02/2008

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