BANDAK PLASTIC SURGERY PLLC (NPI# 1457564213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457564213 |
Entity Type | Organization |
Organization Name | BANDAK PLASTIC SURGERY PLLC |
Practice Address |
4920 Maccorkle Ave Se Charleston WV 25304-2052 |
Practice Telephone | 3049254665 |
Practice Fax Number | 3049254666 |
Mailing Telephone | 3049254665 |
Mailing Fax Number | 3049254666 |
Enumeration Date | 2007-05-08 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. ABDALLA Z BANDAK (OWNER) |
Authorized Official Telephone | 3049254665 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
21839 | WV | Allopathic & Osteopathic Physicians |
Street Address |
4920 MACCORKLE AVE SE |
City | CHARLESTON |
State | WV |
Zip Code | 25304-2052 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811980113 | Abdalla Zackaria Bandak | Surgery | 4920 Maccorkle Ave Se, Charleston, WV 25304-2052 | 2005-08-23 |
1104888171 | Afif S Habash | Pediatrics | 4920 Maccorkle Ave Se, Charleston, WV 25304-2052 | 2006-04-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
Find all providers in zip 25304 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346365418 | William Aaron Ross | Surgery | 210 Brooks St, Suite 200, Charleston, WV 25301-1855 | 2007-03-20 |
1780797449 | Marcelo L. Hochman | Surgery | 2097 Henry Techlenburg Dr, Suite 212 West, Charleston, SC 29416-5739 | 2006-08-16 |
1811980113 | Abdalla Zackaria Bandak | Surgery | 4920 Maccorkle Ave Se, Charleston, WV 25304-2052 | 2005-08-23 |
1891223012 | Sami Paul Tarabishy | Surgery | 169 Ashley Ave Rm 202, Charleston, SC 29425-8905 | 2017-06-01 |
1336328467 | John David Hayes | Surgery | 210 Brooks St, Suite 200, Charleston, WV 25301-1855 | 2007-10-25 |
1871669390 | The Facial Surgery Center | Surgery | 2097 Henry Tecklenburg Dr, Suite 211 West, Charleston, SC 29414-5740 | 2006-11-27 |
1215042155 | Seung-jun O | Surgery | 2097 Henry Tecklenburg Dr, Suite 211 West, Charleston, SC 29414-5740 | 2006-08-20 |
1760405336 | John Robinson | Surgery | 171 Ashley Ave, Charleston, SC 29425-0001 | 2006-07-25 |
1184655862 | Tracy Harvey | Surgery | 2295 Henry Tecklenburg Dr, Charleston, SC 29414-7801 | 2006-07-05 |
1790716488 | Richard Hagerty | Surgery | 261 Calhoun St, Suite 200, Charleston, SC 29401-1371 | 2006-07-05 |
Find all providers in CHARLESTON |
City | CHARLESTON |
Zip Code | 25304 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.