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NPI Code Detail

MEDICARE: AFRA AHSAN GANGI MD

MEDICARE: AFRA AHSAN GANGI 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
1207Q00000XFamily Medicine Physician34941WV

General Provider Information

NPI Number : 1942948716
Entity Type Code : Individual
Provider Name (Legal Business Name) : AFRA AHSAN GANGI MD
Provider Business Mailing Address
First Line : 100 STONEY HILL RD
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-1589
Country : US
Telephone Number : 855-988-2273
Fax Number : 304-285-5401
Provider Business Practice Location Address
First Line : 100 STONEY HILL RD
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-1589
Country : US
Telephone Number : 304-285-5400
Fax Number : 304-285-5401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2022
Last Update Date : 07/14/2025

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