NPI 1609974641 · live from the CMS NPI Registry
Fairmont Neurology Clinic, PLLC
Psychiatry & Neurology, Neurology in Morgantown, WV. National Provider Identifier 1609974641, active.
NPI record
| NPI | 1609974641 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 1188 Pineview Dr Ste 100, Morgantown, WV 26505 |
| Practice phone | 681-285-8755 |
| Mailing address | Po Box 333, Pursglove, WV 26546 |
| Enumerated | September 21, 2006 |
| Last updated | May 31, 2024 |
| Authorized official | Mouhannad Azzouz, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | WV20408 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.