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Individual

DR. MICHELE M MAOUAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
600 SUNCREST TOWN CENTRE DR STE 115, MORGANTOWN, WV 26505-1873
(304) 598-3888
(304) 598-0564
Mailing address
600 SUNCREST TOWN CENTRE DR STE 115, MORGANTOWN, WV 26505-1873
(304) 598-3888
(304) 598-0564

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
21247
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001751643
BCBS
WV
05
3810002533
WV
01
7061507
AETNA
WV
01
WV21249A
HEALTH PLAN
WV
Enumeration date
11/30/2005
Last updated
12/11/2019
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