# MODI MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528178076
- **Authorized official:** JIGNESH J MODI MD PA (PRESIDENT)
- **Authorized official phone:** (304) 204-2430

## Contact information

- **Practice address:** 4605 MACCORKLE AVE SW STE 302, SOUTH CHARLESTON, WV 25309-1311
- **Practice address phone:** (304) 204-2430
- **Practice address fax:** (304) 397-6740
- **Mailing address:** 40 FAIRLAND DRIVE, NITRO, WV 25143
- **Mailing address phone:** (304) 204-2430
- **Mailing address fax:** (304) 397-6740

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 19795 | WV | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 10/20/2017