Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 25MA09524500 | NJ |
N | 208600000X | Surgeon | 25MA09524500 | NJ |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 25MA09524500 | NJ |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 27378 | WV |
NPI | 1003887407 |
---|---|
Provider Name | Ghulam Abbas |
First Address | Morgantown, WV 26506-1200 |
Second Address | Morgantown, WV 26506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 13/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0425729 | (05) | NJ |