Provider Demographics
NPI:1902831779
Name:MOUSA, ALBEIR YOUHANNA (MD)
Entity Type:Individual
Prefix:
First Name:ALBEIR
Middle Name:YOUHANNA
Last Name:MOUSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3200 MACCORKLE AVENUE SE
Mailing Address - Street 2:CAMC VASCULAR CENTER OF EXCELLENCE
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304
Mailing Address - Country:US
Mailing Address - Phone:304-388-8199
Mailing Address - Fax:304-388-8195
Practice Address - Street 1:3200 MACCORKLE AVENUE SE
Practice Address - Street 2:CAMC VASCULAR CENTER OF EXCELLENCE
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304
Practice Address - Country:US
Practice Address - Phone:304-388-8199
Practice Address - Fax:304-388-8195
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV23694207P00000X, 208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810015438Medicaid
WV0931982Medicare PIN
WV3810015438Medicaid