Provider Demographics
NPI:1609444371
Name:KASHGARIAN, ILHAM MAMAT (MD)
Entity type:Individual
Prefix:
First Name:ILHAM
Middle Name:MAMAT
Last Name:KASHGARIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YILAMUJIANG
Other - Middle Name:
Other - Last Name:MAIMAITI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3100 MACCORKLE AVE SE STE B16
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1223
Mailing Address - Country:US
Mailing Address - Phone:304-388-5848
Mailing Address - Fax:304-388-9654
Practice Address - Street 1:3100 MACCORKLE AVE SE STE B16
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1223
Practice Address - Country:US
Practice Address - Phone:304-388-5848
Practice Address - Fax:304-388-9654
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV35449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine