Provider Demographics
NPI:1699279794
Name:ARISHA, MOHAMMED JAMAL AHMED BAYYOUMI (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:JAMAL AHMED BAYYOUMI
Last Name:ARISHA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3100 MACCORKLE AVE SE STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1215
Mailing Address - Country:US
Mailing Address - Phone:304-388-8200
Mailing Address - Fax:
Practice Address - Street 1:3100 MACCORKLE AVE SE STE 101
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1215
Practice Address - Country:US
Practice Address - Phone:304-388-8200
Practice Address - Fax:304-388-7010
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV34055207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease