Individual
DR. PANITAN YOSSUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 STADIUM DRIVE, MORGANTOWN, WV 26506
(304) 598-4800
(304) 293-6963
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
20855
WV
2080P0203X
Pediatric Critical Care Medicine Physician
20855
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1808599000
—
WV
Enumeration date
10/16/2006
Last updated
04/07/2022
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