Provider Demographics
NPI:1265606057
Name:POULS, AFAF YOUSSEF (MD)
Entity type:Individual
Prefix:DR
First Name:AFAF
Middle Name:YOUSSEF
Last Name:POULS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AFAF
Other - Middle Name:YOUSSEF
Other - Last Name:BOTROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 VETERANS AVE
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-6444
Mailing Address - Country:US
Mailing Address - Phone:304-255-2121
Mailing Address - Fax:
Practice Address - Street 1:200 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-6444
Practice Address - Country:US
Practice Address - Phone:304-255-2121
Practice Address - Fax:404-534-9934
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA062276207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA062276OtherGA LICENSE