| Doctor Name: | ABDEL-FATAH MASSOUD |
| NPI Number: | 1396705307 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD,MPH |
| License Number: | 16739 |
| Business Practice Address: | 1 Medical Center Drive Fairmont, WV - 26301 |
| Business Phone Number: | 3046233461 |
| Business Fax Number: | 3046267010 |
| Mailing Address: | 1 Medical Center Drive, FAIRMONT |
| State: | WV |
| Postal Code: | 26301 |
| Phone Number: | 3046233461 |
| Fax Number: | 3046267010 |
| NPI Enumeration Date: | 03/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084A0401X |
| License Number: | 16739 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |