Organization
PROFESSIONAL ENDOCRINOLOGY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMAR R. SANKARI M.D. (OWNER, PHYSICIAN, MANAGING MEMBER)
(304) 720-1963
Entity
Organization
Contact information
Practice address
331 LAIDLEY ST STE 507, PROFESSIONAL ENDOCRINOLOGY ASSOCIATES, PLLC, CHARLESTON, WV 25301-1682
(304) 720-1963
(304) 720-1966
Mailing address
PO BOX 3466, CHARLESTON, WV 25334-3466
(304) 720-1963
(304) 720-1966
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
163WD0400X
Diabetes Educator Registered Nurse
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001803459
BCBS GROUP
WV
05
—
3810004642
—
WV
01
—
DE7709
RR MEDICARE
WV
Enumeration date
07/18/2006
Last updated
10/11/2013
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