Individual
DR. ABDALLA ZACKARIA BANDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4920 MACCORKLE AVE SE, CHARLESTON, WV 25304-2052
(304) 741-5510
Mailing address
4920 MACCORKLE AVE SE, CHARLESTON, WV 25304-2052
(304) 741-5510
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
21839
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2532033
CIGNA
WV
01
—
318939
CARELINK
WV
05
—
3810002535
—
WV
01
—
5531469
AETNA
WV
Enumeration date
08/23/2005
Last updated
07/08/2007
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