Individual
DR. TARAS NEBELUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 340-1651
Mailing address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 340-1651
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
3727
WV
390200000X
Student in an Organized Health Care Education/Training Program
312210
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2495224
—
LA
Enumeration date
03/15/2016
Last updated
06/29/2021
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