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General NPI Number Information
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NPI Number | 1093341612
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Entity Type | Organization
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Legal Business Name | PHYSICIAN ASSOCIATES PLLC
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Dates
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Enumeration Date | 03/15/2020
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Last Update Date | 03/15/2020
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Provider Practice Location Address
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Address Line | 1842 HARPER RD
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City | BECKLEY
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State | WV
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Zip | 25801-3366
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Country | US
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Telephone | 304-237-3487
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Fax |
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Provider Business Mailing Address
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Address Line | 1842 HARPER RD
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City | BECKLEY
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State | WV
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Zip | 25801-3366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NITEESH BHARARA
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Credential | MD
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Telephone | 205-910-7056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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