Provider Demographics
NPI:1679688212
Name:ATTIA, SAFWAT (MD)
Entity Type:Individual
Prefix:DR
First Name:SAFWAT
Middle Name:
Last Name:ATTIA
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 1:104 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2736
Mailing Address - Country:US
Mailing Address - Phone:304-472-3616
Mailing Address - Fax:
Practice Address - Street 1:104 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2736
Practice Address - Country:US
Practice Address - Phone:304-472-3616
Practice Address - Fax:304-472-9849
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV175052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV00776761Medicare PIN
260022647Medicare PIN