Charleston Cardiovascular

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

19813 Issued in WV

Legal business name

CHARLESTON CARDIOVASCULAR

Practice address

331 Laidley St
Suite 402
Charleston, WV 25301-1619

Phone

(304) 792-6275

NPI assigned

Nov 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Omar Hallak, MD

Title

Owner

Phone

(304) 792-6275

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194134400000",
    "number": "1316127665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 LAIDLEY ST",
            "address_2": "SUITE 402",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011619",
            "telephone_number": "304-792-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 LAIDLEY ST",
            "address_2": "SUITE 402",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011619",
            "telephone_number": "304-792-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON CARDIOVASCULAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-04",
        "last_updated": "2007-11-04",
        "status": "A",
        "authorized_official_last_name": "HALLAK",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-792-6275",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "19813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000241000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charleston Area Medical Center, Inc.
• Charleston Area Medical Center, Inc. (CAMC Pharmacy (#2))
• Charleston Area Medical Center, Inc.
• Charleston Area Medical Center, Inc.
• Charleston Cardiology Group PLLC
• Charleston Chiropractic Company PLLC (Charleston Chiropractic Company)
• Charleston Dental Associates
• Charleston Dermatology PLLC
• Charleston Diabetes & Endocrine Consultants, PLLC
• Charleston Digestive Disease, Inc.

• Cardiovascular Disease Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Cardiovascular Disease Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.