Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 13746 | WV |
NPI | 1295827285 |
---|---|
Provider Name | Dr. Fereydoun Zangeneh |
First Address | Morgantown, WV 26507-7000 |
Second Address | Charleston, WV 25302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0112736000 | (05) | WV |
D49397 | (02) |