Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 15497 | WV |
NPI | 1760598403 |
---|---|
Provider Name | Dr. Myra L Chiang |
First Address | Charleston, WV 25302-3302 |
Second Address | Charleston, WV 25302-3302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 07/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C14433 | (02) | WV |