Individual
SAGAR SAI CHENNUPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 PIN OAK LN, KEYSER, WV 26726-5908
(304) 597-3500
Mailing address
100 PIN OAK LN, KEYSER, WV 26726-5908
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/25/2021
Last updated
06/07/2022
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