Organization
APPALACHIAN GASTROENTEROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUSAM MOHAMMAD NAZER M.D.,FACP,FACG (OWNER)
(304) 253-0849
Entity
Organization
Contact information
Practice address
429 CARRIAGE DR, BECKLEY, WV 25801-2805
(304) 253-0849
(304) 253-1573
Mailing address
P.O. BOX 1189, BECKLEY, WV 25802
(304) 253-0849
(304) 253-1573
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
13335
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0071942000
—
WV
Enumeration date
05/31/2007
Last updated
04/21/2011
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