Healthcare Provider Details

I. General information

NPI: 1033155437
Provider Name (Legal Business Name): DARSHANKUMAR ASHWINBHAI DAVE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 MACCORKLE AVE SE SUITE 802
CHARLESTON WV
25304
US

IV. Provider business mailing address

3100 MACCORKLE AVE SE STE 411
CHARLESTON WV
25304-1230
US

V. Phone/Fax

Practice location:
  • Phone: 304-343-4400
  • Fax: 304-345-5005
Mailing address:
  • Phone: 304-343-4400
  • Fax: 304-345-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number21117
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: