Provider Demographics
NPI:1225809213
Name:ALHAWSHABI, AMAL FATEH
Entity Type:Individual
Prefix:
First Name:AMAL
Middle Name:FATEH
Last Name:ALHAWSHABI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3241
Mailing Address - Country:US
Mailing Address - Phone:304-914-5974
Mailing Address - Fax:
Practice Address - Street 1:143 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3241
Practice Address - Country:US
Practice Address - Phone:304-914-5974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1821206228Medicaid
WV125553494Medicaid
WV1356607394Medicaid