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Dr. Mouwafak Ghannam, MD
Specialist in South Charleston, West Virginia
NPI 1952429813

Mouwafak Ghannam is a Specialist based in South Charleston, WV. Mouwafak Ghannam practices in South Charleston, WV and has the professional credentials of MD. The NPI Number for Mouwafak Ghannam is 1952429813 and holds a License No. 10886 (West Virginia).

The current practice location address for Mouwafak Ghannam is 4501 Maccorkle Ave Sw, South Charleston, WV and can be reached out via phone at 304-768-6941 and via fax at 304-768-6919.

Location: 4501 Maccorkle Ave Sw, South Charleston, WV, 25309-1444
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952429813
Provider Name
Mouwafak Ghannam
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
4501 Maccorkle Ave Sw, South Charleston, WV, 25309-1444
Phone Number
304-768-6941
Fax Number
304-768-6919
Provider Enumeration Date
03/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0101288000 05 WV
institution
Provider Business Practice Location Address Details
Address
4501 Maccorkle Ave Sw
City
South Charleston
State
West Virginia
Zip
25309-1444
Phone Number
304-768-6941
Fax Number
304-768-6919
person
Provider Business Mailing Address Details
Address
4501 Maccorkle Ave Sw
City
South Charleston
State
West Virginia
Zip
25309-1444
Phone Number
304-768-6941
Fax Number
304-768-6919
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
10886 (West Virginia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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