| Doctor Name: | MARWAN MARC DIB |
| NPI Number: | 1609033844 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PENDING |
| Business Practice Address: | #1 Healthcare Drive Philippi, WV - 26416 |
| Business Phone Number: | 3044571760 |
| Business Fax Number: | 3044571516 |
| Mailing Address: | #1 Healthcare Drive, PHILIPPI |
| State: | WV |
| Postal Code: | 26416 |
| Phone Number: | 3044571760 |
| Fax Number: | 3044571516 |
| NPI Enumeration Date: | 05/16/2008 |
| NPI Last Update Date: | 05/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PENDING |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |