Individual
MARIETTA BABAYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
313 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1263
(304) 746-3706
(304) 744-8195
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(304) 744-2300
(304) 744-8195
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
20710
WV
208100000X
Physical Medicine & Rehabilitation Physician
35.081228
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185283
UNISON MEDICAID
OH
01
—
001720906
MOUNTAIN STATE BCBS
—
05
—
1808136000
—
WV
01
—
2306972
MOLINA MEDICAID
OH
01
—
250013237
RR MEDICARE
—
01
—
310917085158
CARESOURCE MEDICAID
OH
Enumeration date
05/16/2006
Last updated
09/03/2014
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