Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 21350 | WV |
NPI | 1043323199 |
---|---|
Provider Name | Mr. Adnan Alghadban |
First Address | Bridgeport, WV 26330 |
Second Address | Bridgeport, WV 26330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 03/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2006875000 | (05) | WV |