Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 21117 | WV |
NPI | 1033155437 |
---|---|
Provider Name | Darshankumar Ashwinbhai Dave |
First Address | Charleston, WV 25304-1230 |
Second Address | Charleston, WV 25304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 26/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1841796000 | (05) | WV |
H84081 | (02) |