Organization
ADVANCED DIABETES & ENDOCRINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED N HAQ MD (OWNER)
(304) 933-3864
Entity
Organization
Contact information
Practice address
527 MEDICAL PARK DRIVE, SUITE 103, BRIDGEPORT, WV 26330-9009
(304) 933-3864
(304) 933-3867
Mailing address
527 MEDICAL PARK DRIVE, SUITE 103, BRIDGEPORT, WV 26330-9009
(304) 933-3864
(304) 933-3867
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
19842
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19842
STATE LICENSE
WV
Enumeration date
11/04/2008
Last updated
08/12/2011
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