Individual
ABRAHAM S MITIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 LAIDLEY ST, SUITE 301, CHARLESTON, WV 25301-1619
(304) 346-4400
(304) 346-0704
Mailing address
PO BOX 3970, CHARLESTON, WV 25339-3970
(304) 346-4400
(304) 346-0704
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
22677
WV
207WX0107X
Retina Specialist (Ophthalmology) Physician
35097037
OH
208600000X
Surgery Physician
22677
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2766412
—
OH
05
—
3810009024
—
WV
05
—
7100019950
—
KY
Enumeration date
06/01/2006
Last updated
05/06/2021
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