Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 29628 | WV |
Y | 207RP1001X | Pulmonary Disease | 29628 | WV |
NPI | 1063829349 |
---|---|
Provider Name | Vikhyath Terla |
First Address | Charleston, WV 25304-1228 |
Second Address | Charleston, WV 25304-1228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2014 |
Last Update Date | 18/06/2020 |