# ADVANCED DIABETES & ENDOCRINE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659524635
- **Authorized official:** SYED N HAQ MD (OWNER)
- **Authorized official phone:** (304) 933-3864

## Contact information

- **Practice address:** 527 MEDICAL PARK DRIVE, SUITE 103, BRIDGEPORT, WV 26330-9009
- **Practice address phone:** (304) 933-3864
- **Practice address fax:** (304) 933-3867
- **Mailing address:** 527 MEDICAL PARK DRIVE, SUITE 103, BRIDGEPORT, WV 26330-9009
- **Mailing address phone:** (304) 933-3864
- **Mailing address fax:** (304) 933-3867

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 19842 | WV | Yes |

## Other

- **Enumeration date:** 11/04/2008
- **Last updated:** 08/12/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 19842 | STATE LICENSE | WV |