Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 26694 | WV |
NPI | 1134445653 |
---|---|
Provider Name | Dr. Rajwardhan Yadav |
First Address | Bridgeport, WV 26330-9010 |
Second Address | Bridgeport, WV 26330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 13/10/2015 |