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Individual

DR. SHANTI PORTIA GANESH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, MPH

Contact information

Practice address
1540 SPRING VALLEY DR, PM&R DEPARTMENT (117), HUNTINGTON, WV 25704-9300
(304) 429-6741
Mailing address
1540 SPRING VALLEY DR, PM&R DEPARTMENT (117), HUNTINGTON, WV 25704-9300
(304) 429-6741

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036123418
IL
208100000X
Physical Medicine & Rehabilitation Physician
125050793
IL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
27395
WV

Other

Enumeration date
09/13/2007
Last updated
01/17/2017
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