Organization
ANJANEYULU THAGIRISA, M.D.
Active
Organization
ANJANEYULU THAGIRISA, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANJANEYULU THAGIRISA M.D. (OWNER)
(304) 367-0043
Entity
Organization
Contact information
Practice address
1539 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 367-0043
Mailing address
PO BOX 2990, FAIRMONT, WV 26555-2990
(304) 367-0043
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13341
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810011274
—
WV
Enumeration date
11/28/2007
Last updated
03/13/2008
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