Organization
CHARLESTON PEDIATRIC GROUP INC
Active
Other names
CPG Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOUTASSEM B AYOUBI MD (PRESIDENT)
(304) 925-6970
Entity
Organization
Contact information
Practice address
310 35TH STREET SE, SUITE 21, CHARLESTON, WV 25304-1352
(304) 925-6970
(304) 925-5161
Mailing address
310 35TH STREET SE, SUITE 21, CHARLESTON, WV 25304-1352
(304) 925-6970
(304) 925-5161
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/06/2006
Last updated
08/22/2020
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