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General NPI Number Information
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NPI Number | 1922669837
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Entity Type | Individual
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Provider Name | GAURANG PRABHU MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2019
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 1710 HARPER RD
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City | BECKLEY
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State | WV
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Zip | 25801-3357
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Country | US
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Telephone | 304-256-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 HARPER RD
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City | BECKLEY
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State | WV
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Zip | 25801-3357
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Country | US
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Telephone | 304-256-4100
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35172
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License Number State | WV
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