Provider Demographics
NPI:1902878622
Name:FEGHALI, JOSEPH G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:G
Last Name:FEGHALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HAMPTON CENTER
Mailing Address - Street 2:SUITE D
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-599-6627
Mailing Address - Fax:304-599-1437
Practice Address - Street 1:2000 HAMPTON CENTER
Practice Address - Street 2:SUITE D
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-599-6627
Practice Address - Fax:304-599-1437
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV14782207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
180043620OtherUNITED HEALTHCARE RR
WV0094826000Medicaid
001714980OtherMOUNTAIN STATE BCBS
0594713Medicare UPIN
FE0594713Medicare ID - Type Unspecified
D91242Medicare UPIN