Organization
EVOLUTIONARY HEALTHCARE WEST VIRGINIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUSSIEN BALLOUT MD (OWNER)
(321) 387-9451
Entity
Organization
Contact information
Practice address
3006 MOUNT VERNON RD STE 1075, HURRICANE, WV 25526-0318
(321) 387-9451
Mailing address
1931 19TH PL, VERO BEACH, FL 32960-3555
(321) 387-9451
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
10/09/2025
Last updated
04/17/2026
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