Healthcare Provider Details

I. General information

NPI: 1740404375
Provider Name (Legal Business Name): MUNEEL ABBAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 ALDERSON ST STE 1000
WILLIAMSON WV
25661-3215
US

IV. Provider business mailing address

205 FIELDS WAY UNIT E4
PIKEVILLE KY
41501-8936
US

V. Phone/Fax

Practice location:
  • Phone: 304-236-5902
  • Fax: 307-909-3174
Mailing address:
  • Phone: 304-235-7005
  • Fax: 304-235-0677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23889
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: