Basic Information
| Provider Information | |||||||||
| NPI: | 1720042039 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAJJAR | ||||||||
| FirstName: | SAKIB | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1333 SOUTHVIEW DR | ||||||||
| Address2: | P. O. BOX 1190 | ||||||||
| City: | BLUEFIELD | ||||||||
| State: | WV | ||||||||
| PostalCode: | 247014317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043272907 | ||||||||
| FaxNumber: | 3043272989 | ||||||||
| Practice Location | |||||||||
| Address1: | 1331 SOUTHVIEW DR | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | BLUEFIELD | ||||||||
| State: | WV | ||||||||
| PostalCode: | 247014320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043258171 | ||||||||
| FaxNumber: | 3043253914 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 17140 | WV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 0075276000 | 05 | WV | MEDICAID |