Individual
JOHN PONUGUPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 DIVISION ST, SUITE 100, SOUTH CHARLESTON, WV 25309-1455
(304) 766-4350
(304) 766-4355
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 414-4800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26167
WV
207RH0003X
Hematology & Oncology Physician
Primary
26167
WV
Other
Enumeration date
08/07/2008
Last updated
12/30/2021
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