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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

HEBAH SOUDAN MBBS
NPI 1821784711
Student in an Organized Health Care Education/Training Program in Charleston, WV

Active since April 13, 2023PECOS Enrolled
3100 MACCORKLE AVE SE STE 205, CHARLESTON, WV 25304(304) 388-2303(304) 388-2390 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Hebah Soudan Mbbs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEBAH SOUDAN MBBS (NPI 1821784711) is an individual student in an organized health care education/training program in Charleston, West Virginia and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821784711
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameHEBAH SOUDANCredential: MBBS
Location Address3100 MACCORKLE AVE SE STE 205Charleston, WV 25304-1228
Mailing Address3100 Maccorkle Ave Se Ste 205Charleston, WV 25304-1228 · (304) 388-2303 · Fax (304) 388-2390
Phone(304) 388-2303
Fax(304) 388-2390
Sole ProprietorNo
Enumeration DateApril 13, 2023
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1821784711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 57.255215 (OH)
3100 MACCORKLE AVE SE STE 205, Charleston, WV 25304
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hebah Soudan Mbbs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VIKHYATH TERLA M.D.
Internal Medicine (Pulmonary Disease)
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV 25304
Kanawha County (304) 388-2303
DR. EMILY FRIDENMAKER M.D.
Internal Medicine (Pulmonary Disease)
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV 25304
Kanawha County (304) 388-2303
KAITLIN MCDADE DO
Internal Medicine (Critical Care Medicine)
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV 25304
Kanawha County (304) 388-2303
KATRINA ROSE TILTON C-NP
Nurse Practitioner
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV 25304
Kanawha County (304) 388-2390
DR. TARAKE M. ALJAROD M.D.
Internal Medicine (Pulmonary Disease)
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV 25304
Kanawha County (304) 388-2303
LAURYN B SLACK
Physician Assistant
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV 25304
Kanawha County (304) 388-2303
ADAM THOMAS FANNIN MSN, MHA, APRN-CNP
Registered Nurse (Critical Care Medicine)
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV 25304
Kanawha County (740) 395-6011
DR. LUCAS ALLEN HAMRICK DO
Internal Medicine (Pulmonary Disease)
3100 MACCORKLE AVE SE STE 205
CHARLESTON, WV 25304
Kanawha County (304) 388-2303

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hebah Soudan's NPI number?

The NPI number for Hebah Soudan is 1821784711. It was assigned to this individual provider in the NPPES registry on April 13, 2023.

Where is Hebah Soudan located?

Hebah Soudan practices at 3100 Maccorkle Ave SE Ste 205, Charleston, WV 25304. The listed phone number is (304) 388-2303.

What is Hebah Soudan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Hebah Soudan enrolled in Medicare?

Yes. Hebah Soudan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Hebah Soudan was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.