Sub-Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22493 Issued in WV

Legal business name

SUB-CLINIC, INC

Practice address

5240 1/2 McCorkle Ave SE
Charleston, WV 25304

Phone

(304) 926-2300

Fax

(304) 926-2304

NPI assigned

May 6, 2015

Last updated

May 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mohamad S Kalou, MDNPI 1619065190

Title

Owner

Phone

(304) 926-2300

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohamad Samah Kalou, MD

  • Addiction Medicine (Family Medicine) Physician
  • Charleston, WV
  • NPI 1619065190
  Authorized official Same address or phone

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1285011544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 1/2 MCCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-926-2300",
            "fax_number": "304-926-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 1/2 MCCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-926-2300",
            "fax_number": "304-926-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUB-CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "KALOU",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-926-2300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "22493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annamika Stutler
• Cassandra Stutler
• Jordan Stutler
• Rebecca Stutler
• Tabitha Renee Stutler, CRNA
• Marc A. Subik, M.D.
• Kirsten A Suffecool
• Patrick D Suggs
• Sulaiman B Hasan MD PLLC
• Faroug Yassin Mohmd Suliman, MD

• Family Medicine Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.