Healthcare Provider Details

I. General information

NPI: 1750953535
Provider Name (Legal Business Name): GURLEEN KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 COLLIERS WAY STE 502
WEIRTON WV
26062-5054
US

IV. Provider business mailing address

PO BOX 779
MORGANTOWN WV
26507-0779
US

V. Phone/Fax

Practice location:
  • Phone: 304-797-6699
  • Fax: 304-723-1295
Mailing address:
  • Phone: 304-797-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT223481
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number36003
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: