Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 12021 | WV |
NPI | 1407801558 |
---|---|
Provider Name | Mohammed Ashraf |
First Address | Morgantown, WV 26505 |
Second Address | Morgantown, WV 26505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0094292000 | (05) | WV |
D99696 | (02) |