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Individual

DR. SHASHANK PONUGOTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26505
(304) 293-1964
Mailing address
PO BOX 88, WHITE SULPHUR SPRINGS, WV 24986-0088
(304) 536-5030
(304) 536-5031

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23711
WV
208M00000X
Hospitalist Physician
53981
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000276995
OH UNISON
WV
01
0817345
CIGNA
WV
01
1072968
CARELINK/COVENTRY
WV
05
2969328
OH
05
3810015455
WV
01
613154600
BLACK LUNG/FECA
WV
05
7100084200
KY
Enumeration date
09/10/2008
Last updated
10/31/2025
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