Individual
BASSEL J MOUGHRABI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
65 SHENANDOAH AVE, DALEVILLE, VA 24083-3201
(540) 966-6430
(540) 966-1348
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 373-7600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101059227
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005858534
—
VA
05
—
3002207000
—
WV
01
—
385142
ANTHEM
VA
01
—
385143
ANTHEM
WV
01
—
5208606
AETNA
—
01
—
54183971800
WV WORKERS COMPENSATION
WV
01
—
541839718074
BS MOUNTAIN STATE
WV
Enumeration date
06/16/2005
Last updated
02/08/2022
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