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General NPI Number Information
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NPI Number | 1881856516
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Entity Type | Organization
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Legal Business Name | SAHIB K SHAMMAA, MD INC
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 623 TEMPLE ST
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City | HINTON
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State | WV
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Zip | 25951-2230
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Country | US
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Telephone | 304-466-1243
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Fax | 304-466-6050
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Provider Business Mailing Address
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Address Line | 623 TEMPLE ST POB 370
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City | HINTON
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State | WV
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Zip | 25951-2230
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Country | US
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Telephone | 304-466-1243
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Fax | 304-466-6050
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Authorized Official
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Title or Position | SECRETARY
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Name | GAYLE MARIE BUGG
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Credential |
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Telephone | 304-466-1243
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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 | 10770
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License Number State | WV
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