Organization
RALEIGH LUNG CLINIC INCORPORATED PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMZI N. HADDADIN MD (OWNER)
(304) 255-6300
Entity
Organization
Contact information
Practice address
2401 S KANAWHA ST, SUITE 100, BECKLEY, WV 25801-6967
(304) 255-6300
(304) 255-6301
Mailing address
43 FOX SPARROW RD, BECKLEY, WV 25801-3687
(304) 255-6300
(304) 255-6301
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
20964
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002103799
BCBS
WV
01
—
1059099
ADVANTRA
WV
05
—
3810014810
—
WV
01
—
7530440
AETNA PIN
WV
01
—
B614349000
FECA/ENERGY
WV
Enumeration date
05/14/2009
Last updated
05/05/2014
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