Individual
LEA GRACE RAMOS FAMULARCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1041 HOSPITAL DRIVE, SUITE 306, HURRICANE, WV 25526
(304) 397-5744
(304) 757-0964
Mailing address
4111 1ST AVE, STE 3, NITRO, WV 25143-1345
(304) 397-5744
(304) 757-0964
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24101
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24101
STATE LICENSE
WV
Enumeration date
05/13/2008
Last updated
01/19/2017
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