Individual
BASSEL J MOUGHRABI
Active
Individual
BASSEL J MOUGHRABI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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