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Organization

PEDIATRIC GASTROENTEROLOGY OF CHARLESTON, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AHMED DAHSHAN M.D. (PHYSICIAN/OWNER)
(304) 400-4626
Entity
Organization

Contact information

Practice address
428 DIVISION ST, SUITE 3A, SOUTH CHARLESTON, WV 25309-1469
(304) 400-4626
Mailing address
428 DIVISION ST, SUITE 3A, SOUTH CHARLESTON, WV 25309-1469
(304) 400-4626

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
24418
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
381002088
WV
Enumeration date
07/05/2013
Last updated
11/26/2013
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