MEDICARE: TAOUFIK A SADAT

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	152W00000X	Optometrist
2	156FX1800X	Optician
3	332H00000X	Eyewear Supplier
4	207W00000X	Ophthalmology Physician	20564	WV

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
2	1437241346	OTHER		NPI

General Provider Information

NPI Number	:	1184983694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAOUFIK A SADAT

Provider Business Mailing Address
First Line	:	22 MALLARD CT
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-3615
Country	:	US
Telephone Number	:	304-252-4216
Fax Number	:	304-253-6809

Provider Business Practice Location Address
First Line	:	22 MALLARD CT
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-3615
Country	:	US
Telephone Number	:	304-252-4216
Fax Number	:	304-253-6809

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TAOUFIK SADAT
Credential	:	MD
Telephone Number	:	304-252-4216

Provider Enumeration Date	:	05/04/2012
Last Update Date	:	07/16/2012

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Directions to “TAOUFIK A SADAT ” Practice Location

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