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General NPI Number Information
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NPI Number | 1780613984
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Entity Type | Organization
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Legal Business Name | PLEASANT VALLEY RADIOLOGY
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 2520 VALLEY DR
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City | POINT PLEASANT
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State | WV
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Zip | 25550-2031
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Country | US
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Telephone | 304-675-4340
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Fax | 304-675-5893
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Provider Business Mailing Address
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Address Line | PO BOX 236
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City | POINT PLEASANT
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State | WV
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Zip | 25550-0236
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Country | US
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Telephone | 614-430-5726
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SURESH K AGRAWAL
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Credential | MD
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Telephone | 304-675-4340
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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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