1487864088 NPI number — ZIAD KAHWASH

Table of content: (NPI 1487864088)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487864088 NPI number — ZIAD KAHWASH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZIAD KAHWASH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ZIAD KAHWASH M.D.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487864088
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9236
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH CHARLESTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25309-0236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-766-7236
Provider Business Mailing Address Fax Number:
304-766-7238

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
436 DIVISION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH CHARLESTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25309-1402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-766-7236
Provider Business Practice Location Address Fax Number:
304-766-7238
Provider Enumeration Date:
05/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KAHWASH
Authorized Official First Name:
ZIAD
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
304-766-7236

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  17212 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0077187000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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