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NPI Profile for MOUNTAIN STATE VASCULAR INC in BECKLEY, WV.
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Vascular Surgery |
2086S0129X | 76 | Physician/Peripheral Vascular Disease |
| NPI # | 1104318625 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/31/2018 | |
| Last updated | 05/22/2024 - About 2 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MOUNTAIN STATE VASCULAR, INC.
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MOUNTAIN STATE VASCULAR, INC.