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General NPI Number Information
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NPI Number | 1407819360
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Entity Type | Individual
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Provider Name | ANNA MARIA SURAY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3045 PENNSYLVANIA AVE SUITE 3 LEVEL 1
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City | WEIRTON
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State | WV
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Zip | 26062-3770
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Country | US
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Telephone | 304-723-4000
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Fax | 304-794-7100
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Provider Business Mailing Address
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Address Line | PO BOX 2304
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City | WEIRTON
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State | WV
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Zip | 26062-1504
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Country | US
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Telephone | 304-723-4000
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Fax | 304-794-7100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 18763
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License Number State | WV
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