Healthcare Provider Details

I. General information

NPI: 1790765774
Provider Name (Legal Business Name): LAP-YANG JOSEPH LI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 SUNCREST TOWNE CENTRE
MORGANTOWN WV
26505-1828
US

IV. Provider business mailing address

1202 SUNCREST TOWNE CENTRE
MORGANTOWN WV
26505-1828
US

V. Phone/Fax

Practice location:
  • Phone: 304-599-2004
  • Fax: 304-599-7611
Mailing address:
  • Phone: 304-599-2004
  • Fax: 304-599-7611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number19475
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: