Healthcare Provider Details

I. General information

NPI: 1497786594
Provider Name (Legal Business Name): NABIL GUIRGUIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 THOMPSON DRIVE
BRIDGEPORT WV
26330
US

IV. Provider business mailing address

166 THOMPSON DRIVE
BRIDGEPORT WV
26330
US

V. Phone/Fax

Practice location:
  • Phone: 304-842-6001
  • Fax: 304-842-3113
Mailing address:
  • Phone: 304-842-6001
  • Fax: 304-842-6111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. NABIL G GUIRGUIS
Title or Position: MD EXECUTIVE
Credential: MD
Phone: 304-842-6001