Individual
DR. JALAL B. FATEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DRIVE, VA MEDICAL CENTER, CLARKSBURG, WV 26301
(304) 623-3461
Mailing address
112 JOHNSON AVE, APT. 3, BRIDGEPORT, WV 26330-2611
(304) 623-3461
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35. 035764
OH
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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