Healthcare Provider Details

I. General information

NPI: 1366427445
Provider Name (Legal Business Name): PHYSICAL MEDICINE & REHABILITATION ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COURT STREET SUITE 203
CHARLESTON WV
25301-1654
US

IV. Provider business mailing address

400 COURT STREET SUITE 203
CHARLESTON WV
25301-1654
US

V. Phone/Fax

Practice location:
  • Phone: 304-343-4900
  • Fax: 304-343-9013
Mailing address:
  • Phone: 304-343-4900
  • Fax: 304-343-9013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. H S RAMESH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 304-343-4900