MEDICARE: PETER VARKEY KOCHUPURA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	MD433007	PA
2	207RP1001X	Pulmonary Disease Physician	34119	WV

General Provider Information

NPI Number	:	1184813388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER VARKEY KOCHUPURA M.D.

Provider Business Mailing Address
First Line	:	1200 J D ANDERSON DR
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-3494
Country	:	US
Telephone Number	:	304-598-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 MON HEALTH MEDICAL PARK AVENUE
Second Line	:	SUITE 1102
City	:	MORGANTOWN
State	:	WV
Zip	:	26505
Country	:	US
Telephone Number	:	304-598-2801
Fax Number	:	304-599-6463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	03/31/2026

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