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General NPI Number Information
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NPI Number | 1548544562
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Entity Type | Organization
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Legal Business Name | MORGANTOWN RADIOLOGY ASSOC PC
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 1200 J D ANDERSON DR
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City | MORGANTOWN
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State | WV
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Zip | 26505-3494
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Country | US
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Telephone | 304-598-1297
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Fax |
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Provider Business Mailing Address
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Address Line | 116 PINEHURST LN
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City | GIBSONIA
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State | PA
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Zip | 15044-6085
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Country | US
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Telephone | 412-559-6657
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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. SURENDRA PAWAR
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Credential | MD
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Telephone | 412-559-6657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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