Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 16892 | WV |
NPI | 1053374751 |
---|---|
Provider Name | Nabeel Ghabra |
First Address | Bridgeport, WV 26330-9010 |
Second Address | Bridgeport, WV 26330-9010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 09/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0075244000 | (05) | WV |
F21736 | (02) |