Healthcare Provider Details

I. General information

NPI: 1992159222
Provider Name (Legal Business Name): FATIMA NAQVI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2016
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PENNSYLVANIA AVE
CHARLESTON WV
25302-3351
US

IV. Provider business mailing address

800 PENNSYLVANIA AVE
CHARLESTON WV
25302-3351
US

V. Phone/Fax

Practice location:
  • Phone: 304-414-1880
  • Fax: 304-414-1886
Mailing address:
  • Phone: 304-414-1880
  • Fax: 304-414-1886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD2022-1176
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: