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Individual

DR. FAHAD F. BAFAKIH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20 HOSPITAL DR, DEPARTMENT OF PATHOLOGY, LOGAN, WV 25601-3452
(304) 831-1101
Mailing address
PO BOX 58310, CHARLESTON, WV 25358-0310

Taxonomy

Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
24687
WV
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
24687
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528205515
WV
05
7100360340
KY
Enumeration date
01/13/2009
Last updated
08/16/2019
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