Healthcare Provider Details

I. General information

NPI: 1295231520
Provider Name (Legal Business Name): GURJOT RAJE TOOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROBERT C BYRD CLINICAL TEACHING CENTER, 5TH FLOOR, CAMC 3200 MACCORKLE AVE SE
CHARLESTON WV
25304
US

IV. Provider business mailing address

ROBERT C BYRD CLINICAL TEACHING CENTER, 5TH FLOOR, CAMC 3200 MACCORKLE AVE SE
CHARLESTON WV
25304
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-4600
  • Fax: 304-388-4621
Mailing address:
  • Phone: 304-388-4600
  • Fax: 304-388-4621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: