Provider Demographics
NPI:1386709970
Name:EL-KHATIB, ABBAS YOUSEF (MD)
Entity type:Individual
Prefix:DR
First Name:ABBAS
Middle Name:YOUSEF
Last Name:EL-KHATIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 12TH STREET EXT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2352
Mailing Address - Country:US
Mailing Address - Phone:304-431-5168
Mailing Address - Fax:
Practice Address - Street 1:296 NEW HOPE RD STE 2
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2262
Practice Address - Country:US
Practice Address - Phone:304-425-0345
Practice Address - Fax:304-425-0349
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17908207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301058570OtherLICENSE
F90957Medicare UPIN