Healthcare Provider Details

I. General information

NPI: 1124272224
Provider Name (Legal Business Name): YOUMNA MOUSATTAT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PENNSYLVANIA AVE
CHARLESTON WV
25302-3351
US

IV. Provider business mailing address

800 PENNSYLVANNIA AVE
CHARLESTON WV
25302
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-2525
  • Fax:
Mailing address:
  • Phone: 304-388-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number23244
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number23244
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: