Organization
ALPHA OMEGA MEDICAL PLLC
Active
Other names
Advanded OBGYN Womens Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMAD MOUSA MD (DOCTOR)
(304) 896-5200
Entity
Organization
Contact information
Practice address
77 HOSPITAL DR, LOGAN, WV 25601-3451
(304) 400-6262
Mailing address
PO BOX 119, LOGAN, WV 25601-0119
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24508
STATE LICENSE
WV
Enumeration date
05/23/2017
Last updated
12/06/2023
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