Individual
SHADI ADIB BASHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
743 1/2 WASHINGTON ST W, CHARLESTON, WV 25302-1844
(786) 859-3616
Mailing address
743 1/2 WASHINGTON ST W, CHARLESTON, WV 25302-1844
(786) 859-3616
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IN0009782
WV
Other
Enumeration date
08/24/2020
Last updated
08/26/2020
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