Healthcare Provider Details

I. General information

NPI: 1477988681
Provider Name (Legal Business Name): HOPE VASCULAR SURGICAL ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 07/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 STANAFORD RD
BECKLEY WV
25801-3140
US

IV. Provider business mailing address

P.O. BOX 5536
BECKLEY WV
25801-5536
US

V. Phone/Fax

Practice location:
  • Phone: 304-255-3601
  • Fax: 681-318-3502
Mailing address:
  • Phone: 681-318-3501
  • Fax: 681-318-3502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number24460
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number24660
License Number StateWV

VIII. Authorized Official

Name: OVIE APPRESAI
Title or Position: MANAGING EMPLOYEE
Credential: M.D.
Phone: 681-318-3501