Provider Demographics
NPI:1891770525
Name:JABBOUR, NABIL M (MD)
Entity Type:Individual
Prefix:DR
First Name:NABIL
Middle Name:M
Last Name:JABBOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3120 COLLINS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3305
Mailing Address - Country:US
Mailing Address - Phone:304-599-2733
Mailing Address - Fax:304-599-4428
Practice Address - Street 1:3120 COLLINS FERRY RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3305
Practice Address - Country:US
Practice Address - Phone:304-599-2733
Practice Address - Fax:304-599-4428
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WVWV14244207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0096976000Medicaid
WVD49400Medicare UPIN
WV0096976000Medicaid