MEDICARE: DR. NARENDER RAO JOGENPALLY MD

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	207RH0003X	Hematology & Oncology Physician	18973	WV

General Provider Information

NPI Number	:	1396741880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NARENDER RAO JOGENPALLY MD

Provider Business Mailing Address
First Line	:	4605 MACCORKLE AVE SW
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-1311
Country	:	US
Telephone Number	:	304-414-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 DIVISION ST STE 100
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-1455
Country	:	US
Telephone Number	:	304-766-4350
Fax Number	:	304-766-4355

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	12/27/2021

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