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Individual

DR. PRAKASH RAGHUNATH PURANIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
250 STANAFORD RD, BECKLEY, WV 25801-3140
(304) 466-2944
(304) 466-2943
Mailing address
1802 HARPER RD, STE 102, BECKLEY, WV 25801-3376
(304) 466-2944
(304) 466-2943

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
18189
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000056944C
HUMANA
WV
01
000713093
BLUE CROSS NUMBER
WV
05
0098274000
WV
01
160029519
RAILROAD MEDICARE PIN #
WV
Enumeration date
08/31/2006
Last updated
07/17/2018
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