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General NPI Number Information
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NPI Number | 1427361484
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Entity Type | Organization
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Legal Business Name | HATEM M HOSSINO MD INC
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 07/20/2010
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Provider Practice Location Address
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Address Line | 415 MORRIS ST SUITE 101
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City | CHARLESTON
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State | WV
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Zip | 25301-1842
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Country | US
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Telephone | 304-343-8181
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Fax | 304-343-8247
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Provider Business Mailing Address
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Address Line | 415 MORRIS ST SUITE 101
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City | CHARLESTON
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State | WV
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Zip | 25301-1842
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Country | US
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Telephone | 304-343-8181
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Fax | 304-343-8247
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Authorized Official
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Title or Position | OWNER
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Name | DR. HATEM M HOSSINO
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Credential | M.D.
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Telephone | 304-343-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10690
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License Number State | WV
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