Individual
DR. KHAWAJA OWAIS OMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 MACCORKLE AVE SE STE 700, CHARLESTON, WV 25304-1230
(304) 720-7305
Mailing address
3100 MACCORKLE AVE SE STE 700, CHARLESTON, WV 25304-1230
(304) 720-7305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01069485A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
30789
WV
208M00000X
Hospitalist Physician
2014027663
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201022120
—
IN
Enumeration date
10/07/2008
Last updated
02/11/2022
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