Individual
BASSAM MOUSHMOUSH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 LAIDLEY ST, SUITE 331, CHARLESTON, WV 25301-1619
(304) 347-2042
(304) 347-2091
Mailing address
1211 HOSPITAL DR, HURRICANE, WV 25526-8707
(304) 757-4694
(304) 757-4695
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
16432
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073986000
—
WV
Enumeration date
09/09/2005
Last updated
07/08/2007
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