Healthcare Provider Details

I. General information

NPI: 1629061973
Provider Name (Legal Business Name): LO'AY M. AL-ASADI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 CHESTERFIELD AVE STE 102
CHARLESTON WV
25304-1066
US

IV. Provider business mailing address

2335 CHESTERFIELD AVE STE 103
CHARLESTON WV
25304-1066
US

V. Phone/Fax

Practice location:
  • Phone: 304-925-7676
  • Fax: 304-925-7679
Mailing address:
  • Phone: 304-346-0311
  • Fax: 304-346-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number16919
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number16919
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: