Healthcare Provider Details

I. General information

NPI: 1679783716
Provider Name (Legal Business Name): FRANK J. TRUPO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 LAIDLEY ST SUITE 510
CHARLESTON WV
25301-1619
US

IV. Provider business mailing address

PO BOX 6812
CHARLESTON WV
25362-0812
US

V. Phone/Fax

Practice location:
  • Phone: 304-346-4444
  • Fax: 304-346-6383
Mailing address:
  • Phone: 304-346-4444
  • Fax: 304-346-6383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number14394
License Number StateWV

VIII. Authorized Official

Name: FRANK J TRUPO
Title or Position: OWNER
Credential: MD
Phone: 304-346-4444