Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 199914 | LA |
Y | 207SG0201X | Clinical Genetics (M.D.) | 24597 | WV |
NPI | 1538253570 |
---|---|
Provider Name | Dr. Tarachandra Narumanchi |
First Address | Morgantown, WV 26507-0780 |
Second Address | Morgantown, WV 26506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 07/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1061778 | (05) | LA |
3810021861 | (05) | WV |