Organization
BILAL A ITANI MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILAL A ITANI MD (OWNER)
(304) 788-0202
Entity
Organization
Contact information
Practice address
233 S MINERAL ST, KEYSER, WV 26726-2643
(304) 788-0202
(304) 788-4377
Mailing address
233 S MINERAL ST, KEYSER, WV 26726-2643
(304) 788-0202
(304) 788-4377
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16425
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043316000
—
WV
Enumeration date
01/05/2017
Last updated
01/05/2017
Update your record
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