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Contact Information

ADVANCED DIABETES & ENDOCRINE CENTER
527 MEDICAL PARK DRIVE
SUITE 103
BRIDGEPORT, WV26330-9009
 Phone: 304-933-3864
 Fax: 304-933-3867
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endocrinology, Diabetes & Metabolism

207RE0101X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for ADVANCED DIABETES & ENDOCRINE CENTER

NPI Number 1659524635
LBN Legal business name ADVANCED DIABETES & ENDOCRINE CENTER
Authorized official SYED HAQ - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/04/2008
Last updated 08/12/2011 - About 15 years ago
Identifiers
WV License # 19842
WV Other 19842 STATE LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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