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NPI 1760421648

NPI 1760421648 : DEV RAJ RELLAN MD : HUNTINGTON, WV

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General NPI Number Information
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    NPI Number           |    1760421648
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    Entity Type          |    Individual 
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    Provider Name        |    DEV RAJ RELLAN MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/06/2006
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    Last Update Date     |    12/09/2010
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Provider Practice Location Address
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    Address Line         |    5170 US ROUTE 60 E 
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    City                 |    HUNTINGTON
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    State                |    WV
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    Zip                  |    25705-2004
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    Country              |    US
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    Telephone            |    304-528-4616
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    Fax                  |    304-526-3228
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Provider Business Mailing Address
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    Address Line         |    5170 US ROUTE 60 E 
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    City                 |    HUNTINGTON
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    State                |    WV
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    Zip                  |    25705-2004
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    Country              |    US
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    Telephone            |    304-528-4616
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    Fax                  |    304-526-3228
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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        |    207RN0300X
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    Taxonomy Name        |    Nephrology Physician
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    License Number       |    09827
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    License Number State |    WV
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