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General NPI Number Information
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NPI Number | 1760506018
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Entity Type | Individual
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Provider Name | MOUHANNAD AZZOUZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1188 PINEVIEW DR STE 100
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City | MORGANTOWN
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State | WV
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Zip | 26505-2712
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Country | US
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Telephone | 304-599-7934
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Fax | 304-599-7936
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Provider Business Mailing Address
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Address Line | 1188 PINEVIEW DR STE 100
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City | MORGANTOWN
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State | WV
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Zip | 26505-2712
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Country | US
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Telephone | 681-285-8755
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Fax | 304-825-6577
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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 | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 20408
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 20408
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | WV20408
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License Number State | WV
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