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Contact Information

CHARLESTON RADIATION THERAPY CONSULTANTS PLLC
3415 MACCORKLE AVE SE
CHARLESTON, WV25304
 Phone: 304-388-1790
 Fax: 304-388-1768
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for CHARLESTON RADIATION THERAPY CONSULTANTS PLLC · (Female)

NPI # 1942208145
Status Active
Credentials
Entity Individual
Enumeration date 07/12/2005
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • WV License # 001
  • WV Medicaid 0007557000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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