| Joseph Mouchizadeh, MD | |
|
1521 Maplewood Ave, Ronceverte, WV 24970-8026 | |
| (304) 647-5642 | |
| (304) 647-5708 |
| Full Name | Joseph Mouchizadeh |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 46 Years |
| Location | 1521 Maplewood Ave, Ronceverte, West Virginia |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225024342 | NPI | - | NPPES |
| 1000875000 | Medicaid | WV | |
| 007504268 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 0101232558 (Virginia) | Secondary |
| 208800000X | Urology | 20833 (West Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Greenbrier Valley Medical Center | Ronceverte, WV | Hospital |
| Lewisgale Hospital Alleghany | Low moor, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Camc Greenbrier Valley Medical Center Inc | 1254702962 | 67 |
| Camc Greenbrier Valley Medical Center Inc | 1254702962 | 67 |
| Entity Name | Ronceverte Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306170048 PECOS PAC ID: 3072652767 Enrollment ID: O20091210000009 |
| Entity Name | Camc Greenbrier Valley Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588373872 PECOS PAC ID: 1254702962 Enrollment ID: O20230118000113 |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph Mouchizadeh, MD 176 Dawkins Dr, Lewisburg, WV 24901-9302 Ph: (304) 647-4411 | Joseph Mouchizadeh, MD 1521 Maplewood Ave, Ronceverte, WV 24970-8026 Ph: (304) 647-5642 |
Kyle F Fort, MD Urology Medicare: Medicare Enrolled Practice Location: 1521 Maplewood Ave, Ronceverte, WV 24970 Phone: 304-647-5642 Fax: 304-647-5708 | |
Thomas S Kowalkowski, MD Urology Medicare: May Accept Medicare Assignments Practice Location: 1521 Maplewood Ave, Ronceverte, WV 24970 Phone: 304-647-5642 Fax: 304-647-5708 |