Bandak Plastic Surgery PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

21839 Issued in WV

Legal business name

BANDAK PLASTIC SURGERY PLLC

Practice address

4920 Maccorkle Ave SE
Charleston, WV 25304-2052

Phone

(304) 925-4665

Fax

(304) 925-4666

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Abdalla Z Bandak, M.D.

Title

Owner

Phone

(304) 925-4665

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Afif S Habash, MD

  • Pediatric Adolescent Medicine Physician
  • Charleston, WV
  • NPI 1104888171
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457564213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042052",
            "telephone_number": "304-925-4665",
            "fax_number": "304-925-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042052",
            "telephone_number": "304-925-4665",
            "fax_number": "304-925-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANDAK PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANDAK",
        "authorized_official_first_name": "ABDALLA",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-925-4665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WV",
            "license": "21839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Nicole Balser
• Christine Balser
• Debbie Sue Balser
• Gina Balser
• Tammy Balser
• Abdalla Zackaria Bandak, MD
• Rebecca Bandy
• Thelma Bandy
• Anaya Unique Banks
• Janette Banks

• Plastic and Reconstructive Surgery Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Plastic and Reconstructive Surgery Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.