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ANDYARA EUZEBIO PASSOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3600
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3600

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2742
WV
363AM0700X
Medical Physician Assistant
2742
WV

Other

Enumeration date
06/05/2023
Last updated
09/15/2025
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