Healthcare Provider Details

I. General information

NPI: 1598157430
Provider Name (Legal Business Name): WV HEART AND VASCULAR INSTITUTE CHARLESTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 MACCORKLE AVE SE SUITE 610
CHARLESTON WV
25304-1223
US

IV. Provider business mailing address

4610 KANAWHA AVE SW SUITE 200
SOUTH CHARLESTON WV
25309-1367
US

V. Phone/Fax

Practice location:
  • Phone: 304-346-1141
  • Fax: 304-346-1142
Mailing address:
  • Phone: 304-205-7992
  • Fax: 304-205-7739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIE GHARIB
Title or Position: PRESIDENT
Credential: M.D.
Phone: 304-205-7992