Charleston Pediatric Group Inc

Organization Active NPI Pediatrics Physician · Charleston, WV

NPI 1285793455 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1285793455
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
CHARLESTON PEDIATRIC GROUP INC
Practice address
310 35TH Street SE
Suite 21
Charleston, WV 25304-1352
Phone
(304) 925-6970
Fax
(304) 925-5161
NPI assigned
Dec 6, 2006
Organization subpart
No

Authorized official

Name
Mr. Moutassem B Ayoubi, MD
Title
President
Phone
(304) 925-6970

Practitioners 2

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

National Provider Directory

Locations

310 35th St SE
Ste 21
Charleston, WV 25304
Phone (304) 925-6970

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208000000X Yes

Addresses

Primary practice location

310 35TH Street SE
Suite 21
Charleston, WV 25304-1352

Mailing address

310 35TH Street SE
Suite 21
Charleston, WV 25304-1352
Phone (304) 925-6970

Other names

  • CPG Inc Other name

Other providers in Charleston, WV

All providers in Charleston, WV · Pediatrics Physician in West Virginia

Sources for this page

Verify at the official NPI Registry.