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Individual

SAAD MOSSALLATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
527 MEDICAL PARK DRIVE, SUITE 204, BRIDGEPORT, WV 26330
(304) 933-3800
(304) 933-3815
Mailing address
527 MEDICAL PARK DRIVE, SUITE 204, BRIDGEPORT, WV 26330
(304) 933-3800
(304) 933-3815

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
WV13308
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000421910
BCBS
WV
05
0128388000
WV
01
110025127
RR MEDICARE
WV
Enumeration date
10/03/2006
Last updated
06/09/2011
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