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Individual

BAIRAVA S KUPPUSWAMY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
602 DIVISION ST, PARKERSBURG, WV 26101-5656
(304) 865-5151
(304) 485-3251
Mailing address
602, DIVISION STREET, PARKERSBURG, WV 26101-5652
(304) 865-5151
(304) 485-3251

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22064
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810004637
WV
Enumeration date
09/20/2006
Last updated
04/18/2022
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