Most Relevant Information
Provider Data
| NPI Number: | 1003070194 |
| Provider Name: | EMAD Y MOUSA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207QA0401X |
| Specialty: | Family Medicine |
| License Number: | 24508 |
Most Important Dates
| Enumeration Date: | 07/17/2008 |
| Last Updated: | 03/17/2018 |
Provider Practice Location
77 HOSPITAL DR STE 200
LOGAN
WV
256013451
Practice Location Phone/Fax
| Phone: | 3048965200 |
| Fax: | 3048965300 |
Provider Mailing Location
PO BOX 119
LOGAN
WV
25601
Provider Mailing Phone/Fax
| Phone: | 3048965200 |
| Fax: | 3048965300 |