Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 21944 | WV |
NPI | 1013127638 |
---|---|
Provider Name | Dr. Mohammed Almubarak |
First Address | Morgantown, WV 26507-0897 |
Second Address | Morgantown, WV 26505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 06/01/2021 |