Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 17911 | WV |
Y | 208600000X | Surgeon | 17911 | WV |
N | 2082S0105X | Plastic Hand Surgeon | 17911 | WV |
NPI | 1174582423 |
---|---|
Provider Name | Adel Faltaous |
First Address | Huntington, WV 25705-2078 |
Second Address | Huntington, WV 25705-2078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 17/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0114070000 | (05) | WV |
0984118 | (05) | OH |
64700362 | (05) | KY |
F91791 | (02) | WV |