| Amjad Medical Clinic Pllc | |
|
330 N Eisenhower Dr Beckley WV 25801 | |
| (304) 252-5900 | |
| (604) 252-5915 |
| Full Name | Amjad Medical Clinic Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 330 N Eisenhower Dr, Beckley, West Virginia |
| Authorized Official Name and Position | Quartel-ayne Amjad (OWNER) |
| Authorized Official Contact | 3042525900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amjad Medical Clinic Pllc 330 N Eisenhower Dr Beckley WV 25801 Ph: (304) 252-5900 | Amjad Medical Clinic Pllc 330 N Eisenhower Dr Beckley WV 25801 Ph: (304) 252-5900 |
| NPI Number | 1740599919 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 02/15/2019 |
| Medicare PECOS PAC ID | 5799007795 |
|---|---|
| Medicare Enrollment ID | O20141202001550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740599919 | NPI | - | NPPES |
| 24182 | Other | WV | WV MEDICAL LICENSE |
| 3810019138 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | 24182 (West Virginia) | Secondary |
| Provider Name | Quartel-ayne Amjad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760701437 PECOS PAC ID: 1658564489 Enrollment ID: I20101025000705 |
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