Healthcare Provider Details

I. General information

NPI: 1366378713
Provider Name (Legal Business Name): MUHAMMAD MUSSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 PENNSYLVANIA AVE, SUITE 104 CAMC WOMEN & CHILDREN'S
CHARLESTON WV
25302
US

IV. Provider business mailing address

CAMC WOMEN & CHILDREN'S HOSPITAL PEDIATRICS 830 PENNSYLVANIA AVE, SUITE 104
CHARLESTON WV
25302
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 Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: