Organization
BASSAM N SHAMMA, M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASSAM N SHAMMA MD (OWNER)
(304) 767-7919
Entity
Organization
Contact information
Practice address
4607 MACCORKLE AVE SW STE 301, SOUTH CHARLESTON, WV 25309-1364
(304) 767-7919
(304) 767-7911
Mailing address
4607 MACCORKLE AVE SW STE 301, SOUTH CHARLESTON, WV 25309-1364
(304) 767-7919
(304) 767-7911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16982
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092235000
—
WV
01
—
9021
MEDICARE/TRAVELERS
WV
Enumeration date
05/08/2007
Last updated
05/23/2008
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