Ghannam, Mouwafak
Ghannam, Mouwafak is an sole proprietor health care provider with primary practice located at 4501 Maccorkle Ave Sw Suite 401, South Charleston WV 25309-1444. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Ghannam, Mouwafak can be contacted via phone (304) 768-6941.Contact Information
Primary practice address
4501 Maccorkle Ave Sw Suite 401
South Charleston WV 25309-1444
Phone: (304) 768-6941
Fax: (304) 768-6919
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 10886 | West Virginia |
Profile Details
| NPI number | 1952429813 |
|---|---|
| LBN Legal business name | Ghannam, Mouwafak |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 27th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952429813 | NPPES |
| West Virginia | MEDICAID | 0101288000 |
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