Provider Demographics
NPI:1063669463
Name:HUSSEIN E EL-KHATIB,MD,PLLC
Entity Type:Organization
Organization Name:HUSSEIN E EL-KHATIB,MD,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:EL-KHATIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-767-7850
Mailing Address - Street 1:401 DIVISION ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:S CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1455
Mailing Address - Country:US
Mailing Address - Phone:304-767-7850
Mailing Address - Fax:304-767-7855
Practice Address - Street 1:401 DIVISION ST
Practice Address - Street 2:SUITE 204
Practice Address - City:S CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1455
Practice Address - Country:US
Practice Address - Phone:304-767-7850
Practice Address - Fax:304-767-7855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV177712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0116193000Medicaid
WV0116193000Medicaid
WVEL0824672Medicare PIN