| NPI | 1316127665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR HALLAK Owner 304-792-6275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 19813) |
| Enumeration Date | 2007-11-04 |
| Last Update Date | 2007-11-04 |