Provider Demographics
NPI:1730314998
Name:ALRABADI, ANMAR NASER (MD)
Entity type:Individual
Prefix:
First Name:ANMAR
Middle Name:NASER
Last Name:ALRABADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 ROXALANA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-1942
Mailing Address - Country:US
Mailing Address - Phone:304-989-6416
Mailing Address - Fax:
Practice Address - Street 1:24 MACCORKLE AVE SW
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1476
Practice Address - Country:US
Practice Address - Phone:304-720-5000
Practice Address - Fax:304-720-5003
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24458174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV24458OtherSTATE LICENSE