DR. MOUWAFAK GHANNAM (NPI# 1952429813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952429813 |
| Entity Type | Individual |
| Full Name | DR. MOUWAFAK GHANNAM |
| Credential | M.D. |
| Practice Address |
4501 Maccorkle Ave Sw Suite 401 South Charleston WV 25309-1444 |
| Practice Telephone | 3047686941 |
| Practice Fax Number | 3047686919 |
| Mailing Telephone | 3047686941 |
| Mailing Fax Number | 3047686919 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 10886 | WV | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0101288000 | 05 |
| Street Address |
4501 MACCORKLE AVE SW SUITE 401 |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386639243 | Larry Douglas Curnutte | Obstetrics & Gynecology | 4501 Maccorkle Ave Sw, Suite 200, South Charleston, WV 25309-1444 | 2005-09-16 |
| 1821453192 | Bee Well Pharmacy Inc. | Pharmacy | 4501 Maccorkle Ave Sw, South Charleston, WV 25309-1444 | 2015-12-30 |
| 1811161524 | Woman Care Clinic Inc | Obstetrics & Gynecology | 4501 Maccorkle Ave Sw, Suite 200, South Charleston, WV 25309-1444 | 2008-04-15 |
| 1215126990 | Comprecare Services, Inc | Durable Medical Equipment & Medical Supplies | 4501 Maccorkle Ave Sw, Suite 101, South Charleston, WV 25309-1444 | 2007-10-18 |
| 1649476169 | Michael L. Harris Md, Ltd | Eyewear Supplier (Equipment, not the service) | 4501 Maccorkle Ave Sw, Suite 500, South Charleston, WV 25309-1444 | 2007-06-22 |
| 1174649347 | Metamorphosis Counseling, Inc | Counselor | 4501 Maccorkle Ave Sw, Suite 103, South Charleston, WV 25309-1444 | 2007-03-21 |
| 1790819373 | Prestige Primary Care Associates, Pllc | Internal Medicine | 4501 Maccorkle Ave Sw, Suite 301, South Charleston, WV 25309-1444 | 2007-03-15 |
| 1841373529 | Gary D Harris | Audiologist | 4501 Maccorkle Ave Sw, Suite 402, South Charleston, WV 25309-1444 | 2006-10-24 |
| 1730260399 | Michael L. Harris, M.d., Ltd. | Ophthalmology | 4501 Maccorkle Ave Sw, Suite 500, South Charleston, WV 25309-1444 | 2006-10-18 |
| 1841388550 | Randall Alan Clifford | Counselor | 4501 Maccorkle Ave Sw, Ste 103, South Charleston, WV 25309-1444 | 2006-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518371988 | Wv Medical Services, Inc | Specialist | 4816 1/2 Pennsylvania Ave Sw, South Charleston, WV 25309-1337 | 2014-06-13 |
| 1700126257 | Gilbert Goliath Md Pllc | Specialist | 4607 Maccorkle Ave Sw Suite 400, South Charleston, WV 25309 | 2013-02-20 |
| 1053594267 | Mary Elizabeth Taylor | Specialist | 117 7th Avenue, South Charleston, WV 25303 | 2007-12-11 |
| 1700086717 | Charleston Obstetrics and Gynecology Associates Pllc | Specialist | 4607 Maccorkle Ave Sw Ste 201, South Charleston, WV 25309-1364 | 2007-07-19 |
| 1649475914 | Solutions Positive Behavior Strategies, LLC | Specialist | 1 Oak Drive, South Charleston, WV 25309 | 2007-06-18 |
| 1710198858 | Kimberly Dawn Warren | Specialist | 4834 Maccorkle Ave Sw, South Charleston, WV 25309-1340 | 2007-05-24 |
| 1750594529 | Bassam N Shamma, M.d., Pllc | Specialist | 4607 Maccorkle Ave Sw Ste 301, South Charleston, WV 25309-1364 | 2007-05-08 |
| 1669508438 | Kanawha Valley Heart Specialists | Specialist | 4610 Kanawha Ave, Sw, Suite 200, South Charleston, WV 25309-1320 | 2007-02-26 |
| 1578620696 | Badshah J. Wazir | Specialist | 428 Division St, South Charleston, WV 25309-1469 | 2007-01-02 |
| 1730280694 | Osterman Cotes | Specialist | 500 Poplar Street, Suite 200, South Charleston, WV 25309-1474 | 2006-09-25 |
| Find all providers in SOUTH CHARLESTON | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
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| 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.