Organization
APPALACHIAN ADDICTION MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMAD MOUSA MD (OWNER/PHYSICIAN)
(304) 896-5200
Entity
Organization
Contact information
Practice address
77 HOSPITAL DRIVE, SUITE 100 KRUGER BUILDING, LOGAN, WV 25601
(304) 896-5200
(304) 896-5300
Mailing address
77 HOSPITAL DRIVE, SUITE 100 KRUGER BUILDING, LOGAN, WV 25601
(304) 896-5200
(304) 896-5300
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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