Organization
M I DABABNAH MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOUSA I DABABNAH M.D (PRESIDENT)
(304) 255-4845
Entity
Organization
Contact information
Practice address
856 S. RITTER DR., BEAVER, WV 25813
(304) 255-4845
(304) 255-4845
Mailing address
PO BOX 247, 856 S. RITTER DR, BEAVER, WV 25813-0247
(304) 255-4845
(304) 255-4845
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
10670
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134848
UMWA
WV
05
—
3810009229
—
WI
01
—
8750169013
ME
WV
Enumeration date
03/20/2007
Last updated
06/21/2018
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