Organization
MED SURG EYE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAOUFIK A SADAT M.D. (PRESIDENT)
(304) 252-4216
Entity
Organization
Contact information
Practice address
22 MALLARD CT, BECKLEY, WV 25801-3615
(304) 252-4216
(304) 253-6809
Mailing address
PO BOX 172, STANAFORD, WV 25927-0172
(304) 252-4216
(304) 253-6809
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
156FX1800X
Optician
—
—
207W00000X
Ophthalmology Physician
20564
WV
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437241346
NPI
WV
05
—
1841345000
—
WV
01
—
7169950001
DMERC, PTAN
WV
01
—
SA4049742
MEDICARE PROVIDER NUMBER
WV
Enumeration date
02/06/2014
Last updated
11/14/2014
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