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Individual

DR. SIVA PRASAD MARUBOYINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
527 MEDICAL PARK DR STE 402W, BRIDGEPORT, WV 26330-9010
(681) 342-3690
(681) 342-3695
Mailing address
527 MEDICAL PARK DR STE 402W, BRIDGEPORT, WV 26330-9010
(681) 342-3690
(681) 342-3695

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
25MA10445200
NJ
207RG0100X
Gastroenterology Physician
Primary
31030
WV

Other

Enumeration date
07/17/2015
Last updated
08/09/2023
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