Individual
RIDA S MAZAGRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 MEDICAL CENTER DRIVE, SUITE B500, HUNTINGTON, WV 25701
(304) 691-1787
(304) 691-8711
Mailing address
1600 MEDICAL CENTER DRIVE, SUITE B500, HUNTINGTON, WV 25701
(304) 691-1787
(304) 691-8711
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
21133
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2004750000
—
WV
05
—
2406471
—
OH
05
—
64068406
—
KY
Enumeration date
10/03/2006
Last updated
05/09/2013
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