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NPI 1205712064

NPI 1205712064 : ZAINAB RIADH : MORGANTOWN, WV

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General NPI Number Information
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    NPI Number           |    1205712064
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    Entity Type          |    Individual 
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    Provider Name        |    ZAINAB RIADH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/14/2025
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    Last Update Date     |    08/14/2025
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Provider Practice Location Address
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    Address Line         |    451 SUNCREST TOWN CENTRE DR 
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    City                 |    MORGANTOWN
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    State                |    WV
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    Zip                  |    26505-1814
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    Country              |    US
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    Telephone            |    304-293-5831
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    316 BAY ST 
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    City                 |    MORGANTOWN
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    State                |    WV
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    Zip                  |    26508-1812
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    Country              |    US
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    Telephone            |    267-610-7145
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223P0300X
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    Taxonomy Name        |    Periodontics
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    License Number       |    IP2407
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    License Number State |    WV
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