Healthcare Provider Details

I. General information

NPI: 1386635258
Provider Name (Legal Business Name): OAK HILL PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 MAIN ST W
OAK HILL WV
25901-3413
US

IV. Provider business mailing address

PO BOX 787
CRAB ORCHARD WV
25827-0787
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-8884
  • Fax: 304-469-8884
Mailing address:
  • Phone: 304-253-5793
  • Fax: 304-253-0166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. MAHAMMAD A ASHIR
Title or Position: PRESIDENT
Credential: MD
Phone: 304-469-8884