Jalal B. Fatemi, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

35. 035764 Issued in OH

Practice address

1 Medical Center Drive
VA Medical Center
Clarksburg, WV 26301

Phone

(304) 623-3461

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881779759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 JOHNSON AVE",
            "address_2": "APT. 3",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263302611",
            "telephone_number": "304-623-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "address_2": "VA MEDICAL CENTER",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-623-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATEMI",
        "first_name": "JALAL",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35. 035764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.