Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 23778 | WV |
NPI | 1023215548 |
---|---|
Provider Name | Dr. Swapna Gayam |
First Address | Morgantown, WV 26507-0780 |
Second Address | Morgantown, WV 26506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 12/01/2021 |