Healthcare Provider Details

I. General information

NPI: 1235229246
Provider Name (Legal Business Name): BRIJINDER S KOCHHAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 PENNSYLVANIA AVE
WEIRTON WV
26062-3765
US

IV. Provider business mailing address

2950 PENNSYLVANIA AVE
WEIRTON WV
26062-3765
US

V. Phone/Fax

Practice location:
  • Phone: 304-723-2527
  • Fax: 304-723-2543
Mailing address:
  • Phone: 304-723-2527
  • Fax: 304-723-2543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35046027
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number12842
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: