Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 20710 | WV |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 35.081228 | OH |
NPI | 1033161666 |
---|---|
Provider Name | Marietta Babayev |
First Address | Gallipolis, OH 45631-1560 |
Second Address | South Charleston, WV 25303-1263 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 03/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000185283 | UNISON MEDICAID (01) | OH |
001720906 | MOUNTAIN STATE BCBS (01) | |
1808136000 | (05) | WV |
2306972 | MOLINA MEDICAID (01) | OH |
250013237 | RR MEDICARE (01) | |
310917085158 | CARESOURCE MEDICAID (01) | OH |
G84345 | (02) |