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GHALI IBRAHIM-BACHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
310 35TH ST SE, SUITE 11, CHARLESTON, WV 25304-1352
(304) 720-9595
(304) 720-9596
Mailing address
310 35TH ST SE, SUITE 11, CHARLESTON, WV 25304-1352
(304) 720-9595
(304) 720-9596

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19464
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0082173000
WV
Enumeration date
09/20/2006
Last updated
07/24/2013
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