Provider Demographics
NPI:1861426975
Name:KARAM, JEBRAN GEORGE (MD)
Entity type:Individual
Prefix:
First Name:JEBRAN
Middle Name:GEORGE
Last Name:KARAM
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 1:1836 HARPER RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801
Mailing Address - Country:US
Mailing Address - Phone:304-250-0200
Mailing Address - Fax:304-250-0203
Practice Address - Street 1:1836 HARPER RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:304-250-0200
Practice Address - Fax:304-250-0203
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17139207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1802204000Medicaid
F65783Medicare UPIN
WV0747683Medicare PIN