Provider Demographics
NPI:1386670693
Name:AL-HAJJ, GABRIEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:E
Last Name:AL-HAJJ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:400 DIVISION ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1459
Mailing Address - Country:US
Mailing Address - Phone:304-768-0989
Mailing Address - Fax:304-768-1148
Practice Address - Street 1:400 DIVISION ST
Practice Address - Street 2:SUITE 7
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1459
Practice Address - Country:US
Practice Address - Phone:304-768-0989
Practice Address - Fax:304-768-1148
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV10871208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0127244000Medicaid
WV0127244000Medicaid
WVD49471Medicare UPIN