Organization Active NPI

Muhib S. Tarakji M.D.

  • Specialist
  • South Charleston, WV
National Provider Identifier
1124147384
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
11488 Issued in WV
Legal business name
MUHIB S. TARAKJI M.D.
Practice address
418 Greenway Ave
South Charleston, WV 25309-1426
Phone
(304) 766-2101
Fax
(304) 766-2225
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Muhib S. Tarakji, M.D.NPI 1477513968
Title
Physician
Phone
(304) 766-2101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 11488 WV Primary

Addresses

Primary practice location

418 Greenway Ave
South Charleston, WV 25309-1426

Mailing address

418 Greenway Ave
South Charleston, WV 25309-1426
Phone (304) 766-2101

Other identifiers 1

IdentifierTypeStateIssuer
0096577001MedicaidWV

National Provider Directory

National Provider Directory

Locations

418 Greenway Ave
South Charleston, WV 25309
Phone (304) 766-2101

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124147384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 GREENWAY AVE",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091426",
            "telephone_number": "304-766-2101",
            "fax_number": "304-766-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 GREENWAY AVE",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091426",
            "telephone_number": "304-766-2101",
            "fax_number": "304-766-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUHIB S. TARAKJI M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TARAKJI",
        "authorized_official_first_name": "MUHIB",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "304-766-2101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "11488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096577001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.