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1164471546

NPI Code Detail

MEDICARE: DR. HOSSAM SALEH TARAKJI MD

MEDICARE: DR. HOSSAM SALEH TARAKJI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	35.089254	OH
2	207P00000X	Emergency Medicine Physician	20648	WV
3	207R00000X	Internal Medicine Physician	16781	MS
4	207R00000X	Internal Medicine Physician	MD.21573	AL
5	207R00000X	Internal Medicine Physician	036-069197	IL
6	207R00000X	Internal Medicine Physician	35.089254	OH

General Provider Information

NPI Number	:	1164471546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOSSAM SALEH TARAKJI MD

Provider Business Mailing Address
First Line	:	1400 HOSPITAL DR
Second Line	:
City	:	HURRICANE
State	:	WV
Zip	:	25526-9202
Country	:	US
Telephone Number	:	304-757-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 HOSPITAL DR
Second Line	:
City	:	HURRICANE
State	:	WV
Zip	:	25526-9202
Country	:	US
Telephone Number	:	304-757-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	12/06/2022

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Directions to “ DR. HOSSAM SALEH TARAKJI MD” Practice Location

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