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General NPI Number Information
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NPI Number | 1245618677
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Entity Type | Organization
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Legal Business Name | BECKLEY CARDIOLOGY, PLLC
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 1832 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 | 681-207-7129
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Fax | 681-207-7132
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Provider Business Mailing Address
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Address Line | 1832 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 | 681-207-7129
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Fax | 681-207-7132
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. GANESH ASAITHAMBI
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Credential | MD
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Telephone | 681-207-7129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 24136
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 24076
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License Number State | WV
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