Healthcare Provider Details

I. General information

NPI: 1992354344
Provider Name (Legal Business Name): ROUBA SAYEGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 BIRCH ST
MORGANTOWN WV
26505-3418
US

IV. Provider business mailing address

375 BIRCH ST
MORGANTOWN WV
26505-3418
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-0182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number33616
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: