Provider Demographics
NPI:1881733384
Name:ALMASHAT, JAFAR TAKI (MD)
Entity type:Individual
Prefix:DR
First Name:JAFAR
Middle Name:TAKI
Last Name:ALMASHAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JARAR
Other - Middle Name:
Other - Last Name:MASHAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 MARSTON DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-8794
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:235 S WATER ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-4241
Practice Address - Country:US
Practice Address - Phone:304-263-8954
Practice Address - Fax:304-264-0763
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV189582084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVG58830Medicare UPIN