Individual
MR. MOUTASSEM B. AYOUBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 35TH ST SE, SUITE 21, CHARLESTON, WV 25304-1352
(304) 925-6970
(304) 925-5161
Mailing address
310 35TH ST SE, SUITE 21, CHARLESTON, WV 25304-1352
(304) 925-6970
(304) 925-5161
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
09974
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112057000
—
WV
Enumeration date
12/15/2006
Last updated
07/08/2007
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