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Individual

DR. BASSAM NICHOLAS SHAMMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4607 MACCORKLE AVE SW, STE 301, SOUTH CHARLESTON, WV 25309-1364
(304) 767-7919
(304) 767-7911
Mailing address
4607 MACCORKLE AVE SW, STE 301, SOUTH CHARLESTON, WV 25309-1364
(304) 767-7919
(304) 767-7911

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
16982
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0092235000
WV
Enumeration date
06/23/2005
Last updated
07/08/2007
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