Mountaineer Family Medicine, Inc.

LBN: Mountaineer Family Medicine, Inc.
Mountaineer Family Medicine, Inc. is an health care organization with primary practice located at 500 Poplar St Suite 204, Charleston WV 25309-1474. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Mountaineer Family Medicine, Inc. can be contacted via phone (304) 767-7840, or through Kalou, Mohamad Samah via phone (304) 767-7840.

Contact Information

Primary practice address
500 Poplar St Suite 204 Charleston WV 25309-1474
Phone: (304) 767-7840
Fax: (304) 767-7849
Website:
Map and Directions
Authorized official contact:
Name: Kalou, Mohamad Samah Doctor of Medicine (MD)
Phone: (304) 767-7840

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22493 West Virginia

Profile Details

NPI number 1295874436
LBN Legal business name Mountaineer Family Medicine, Inc.
DBA Doing business as
Authorized official Kalou, Mohamad Samah Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 5th, 2007
Last updated Feb 4th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295874436 NPPES
West Virginia MEDICAID 3810010965

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