Provider Demographics
NPI:1427498781
Name:SAYYID, IBRAHIM (MB,BS)
Entity type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:
Last Name:SAYYID
Suffix:
Gender:M
Credentials:MB,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 MEDICAL CENTER DRIVE
Mailing Address - Street 2:PO BOX 9156
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506
Mailing Address - Country:US
Mailing Address - Phone:304-293-0709
Mailing Address - Fax:304-293-2544
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-293-0709
Practice Address - Fax:304-293-2544
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298591207R00000X
PAMD458363208M00000X
WV30626207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASA521531Medicare PIN