Provider Demographics
NPI:1316110877
Name:HAJ MEDICAL CORPORATION
Entity type:Organization
Organization Name:HAJ MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:ARSHAD
Authorized Official - Last Name:JAFARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-929-0786
Mailing Address - Street 1:330 N EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-4141
Mailing Address - Country:US
Mailing Address - Phone:304-929-0786
Mailing Address - Fax:304-929-2278
Practice Address - Street 1:330 N. EISEHOWER DRIVE
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:304-929-0786
Practice Address - Fax:304-929-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV230542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty