Healthcare Provider Details

I. General information

NPI: 1679574644
Provider Name (Legal Business Name): MOHAMMAD JAVED RANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: M. JAVED RANA M.D.

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 LEATHERWOOD LN
BLUEFIELD VA
24605-2026
US

IV. Provider business mailing address

2003 LEATHERWOOD LN
BLUEFIELD VA
24605-2026
US

V. Phone/Fax

Practice location:
  • Phone: 276-322-0000
  • Fax: 276-322-0003
Mailing address:
  • Phone: 276-322-0000
  • Fax: 276-322-0003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number18953
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: