Individual
DR. PETAIAH MOHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
194 CARRIAGE DR, BECKLEY, WV 25801-2804
(304) 255-6051
(304) 255-6051
Mailing address
1710 HARPER RD, BECKLEY, WV 25801-3357
(304) 255-6051
(304) 255-6051
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
18400
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110044000
—
WV
Enumeration date
10/28/2006
Last updated
12/14/2018
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