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General NPI Number Information
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NPI Number | 1689179822
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Entity Type | Individual
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Provider Name | DHURBA PRASAD DHUNGANA MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 912 SOMERSET BLVD STE 101
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City | CHARLES TOWN
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State | WV
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Zip | 25414-3954
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Country | US
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Telephone | 304-725-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 154 HOSPITAL DR STE 4
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City | TYRONE
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State | PA
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Zip | 16686-1829
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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 |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME149222
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | MD478645
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 33552
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License Number State | WV
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