Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 11338 | WV |
NPI | 1003816125 |
---|---|
Provider Name | Arunthathie Rajaratnam |
First Address | Charleston, WV 25334-3444 |
Second Address | Charleston, WV 25304-1477 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 15/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0060316000 | (05) | WV |
E19543 | (02) | WV |