Provider Demographics
NPI:1174582423
Name:FALTAOUS, ADEL (MD)
Entity type:Individual
Prefix:
First Name:ADEL
Middle Name:
Last Name:FALTAOUS
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 1:5185 US ROUTE 60 E
Mailing Address - Street 2:SUITE 26
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2078
Mailing Address - Country:US
Mailing Address - Phone:304-691-8910
Mailing Address - Fax:304-691-1860
Practice Address - Street 1:5185 US ROUTE 60 E
Practice Address - Street 2:SUITE 26
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2078
Practice Address - Country:US
Practice Address - Phone:304-691-8910
Practice Address - Fax:304-691-1860
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV179112082S0105X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0984118Medicaid
WV0114070000Medicaid
KY64700362Medicaid
OH0984118Medicaid
WV0114070000Medicaid