Individual
LARISSA CASABURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6040 UNIVERSITY TOWN CENTRE DR, MORGANTOWN, WV 26501
(304) 293-6307
Mailing address
6040 UNIVERSITY TOWN CENTRE DR, MORGANTOWN, WV 26501-2421
(304) 293-6307
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101258349
VA
2085R0202X
Diagnostic Radiology Physician
Primary
1010
WV
2085R0202X
Diagnostic Radiology Physician
195
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
195
LICENSE
NE
Enumeration date
12/28/2006
Last updated
01/09/2021
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