MEDICARE: MARK ANTHONY CHOUEIRI 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	208600000X	Surgery Physician	21843	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00273599	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225024755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ANTHONY CHOUEIRI MD

Provider Business Mailing Address
First Line	:	3100 MACCORKLE SEAVE 408
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-1230
Country	:	US
Telephone Number	:	304-388-5120
Fax Number	:	304-388-5125

Provider Business Practice Location Address
First Line	:	3100 MACCORKLE AVE SE
Second Line	:	STE 408
City	:	CHARLESTON
State	:	WV
Zip	:	25304-1223
Country	:	US
Telephone Number	:	304-388-5280
Fax Number	:	304-388-5291

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	12/17/2015

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