Individual
SUSAN RENEE AYOUBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 414-1880
(304) 414-1886
Mailing address
97 GREAT TEAYS BLVD, STE 6, SCOTT DEPOT, WV 25560-9815
(304) 757-6999
(304) 201-2019
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24635
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/07/2009
Last updated
07/05/2019
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