ALPHA OMEGA MEDICAL PLLC (NPI# 1497283352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497283352 |
| Entity Type | Organization |
| Organization Name | ALPHA OMEGA MEDICAL PLLC |
| Other Organization Name | ADVANDED OBGYN WOMENS CENTER |
| Practice Address |
77 Hospital Dr Logan WV 25601-3451 |
| Mailing Address |
Po Box 119 Logan WV 25601-0119 |
| Practice Telephone | 3044006262 |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-23 |
| Authorized Official Name | DR. EMAD MOUSA (DOCTOR) |
| Authorized Official Telephone | 3044006262 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
24508 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | STATE LICENSE | 24508 | 01 |
| Other Name | Type Code |
|---|---|
| Advanded OBGYN Womens Center | Doing Business As Name - Organization |
| Street Address |
77 HOSPITAL DR |
| City | LOGAN |
| State | WV |
| Zip Code | 25601-3451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124019997 | Michael Brian Beres | Ophthalmology | 77 Hospital Dr, Suite 400, Logan, WV 25601-3451 | 2005-11-02 |
| 1396092508 | Nicole Lackey Dillon, Md, Inc | Family Medicine | 77 Hospital Dr, Doctors Park Suite D, Logan, WV 25601-3451 | 2012-08-07 |
| 1629295340 | Premier Diagnostic Solutions | Radiology | 77 Hospital Dr, Ste 300, Logan, WV 25601-3451 | 2007-04-20 |
| 1518058817 | Vision Consultants Pllc | Ophthalmology | 77 Hospital Dr, Suite 400, Logan, WV 25601-3451 | 2006-09-28 |
| 1013940196 | Carlton L W Herald Do PC Inc | Internal Medicine | 77 Hospital Dr, Suite 100, Logan, WV 25601-3451 | 2006-07-09 |
| 1497714737 | Jodi M Cisco-goff | Surgery | 77 Hospital Dr, Logan, WV 25601-3451 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689805 | Appalachian Medical LLC | Durable Medical Equipment & Medical Supplies | 218 Dingess St, Logan, WV 25601 | 2020-11-04 |
| 1184224909 | Pamela Gail Hamlin | Technician | 123 Cassick Street, Logan, WV 25601 | 2020-10-30 |
| 1134607344 | Allyson Christa Mckinney | Occupational Therapy Assistant | 55 Lmmh Center Road, Logan, WV 25601 | 2018-07-31 |
| 1841783727 | Erica Lupson | Nurse Practitioner | 3 Mile Curve, Logan, WV 25601 | 2018-06-14 |
| 1861930836 | Joseph Michael Mounts | Counselor | 312 Hudgins St, Logan, WV 25601 | 2017-02-09 |
| 1932647385 | Melissa Campbell | Occupational Therapy Assistant | Wv-10, Logan, WV 25601 | 2017-02-06 |
| 1356891659 | Brooke Bell | Pharmacist | Route 44 Holden Rd, Logan, WV 25601 | 2016-10-11 |
| 1760886469 | April Workman | Massage Therapist | 19 A Main Avenue, Logan, WV 25601 | 2014-10-09 |
| 1366889081 | Ashley Leann Dingess | Physical Therapy Assistant | 55 Logan Mingo Mental Health, Logan, WV 25601 | 2013-06-04 |
| 1528361466 | Health Care Management, LLC | Pharmacy | 369 George Kostas Drive, Logan, WV 25601 | 2010-12-15 |
| Find all providers in zip 25601 | ||||
| Taxonomy Code | 207VX0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Obstetrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508102310 | Cabell Huntington Hospital, Inc | Obstetrics & Gynecology | 1660 12th Ave, Huntington, WV 25701 | 2012-12-26 |
| 1780810192 | Kelly Michele Devoogd | Obstetrics & Gynecology | 651 Colliers Way, Suite 201, Weirton, WV 26062-5053 | 2009-06-01 |
| 1982864799 | Aaron Rockney Parry II | Obstetrics & Gynecology | 830 Pennsylvania Ave, Suite 301, Charleston, WV 25302-3302 | 2008-06-15 |
| 1720262546 | Osterman Cotes, M.d. Pllc | Obstetrics & Gynecology | 500 Poplar St, Suite 200, South Charleston, WV 25309-1474 | 2007-12-28 |
Please comment or provide details below to improve the information on ALPHA OMEGA MEDICAL PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.