Healthcare Provider Details

I. General information

NPI: 1528165214
Provider Name (Legal Business Name): INAS HASSAN AL-ATTAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 NEW HOPE RD STE 3
PRINCETON WV
24740-2354
US

IV. Provider business mailing address

34 NEW HOPE RD STE 3
PRINCETON WV
24740-2354
US

V. Phone/Fax

Practice location:
  • Phone: 304-487-0415
  • Fax: 304-487-0417
Mailing address:
  • Phone: 304-487-0415
  • Fax: 304-487-0417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number18061
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: