Healthcare Provider Details

I. General information

NPI: 1891770525
Provider Name (Legal Business Name): NABIL M. JABBOUR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 COLLINS FERRY RD
MORGANTOWN WV
26505-3305
US

IV. Provider business mailing address

3120 COLLINS FERRY RD
MORGANTOWN WV
26505-3305
US

V. Phone/Fax

Practice location:
  • Phone: 304-599-2733
  • Fax: 304-599-4428
Mailing address:
  • Phone: 304-599-2733
  • Fax: 304-599-4428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberWV14244
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: