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Individual

DANA EUGENE BRAGG

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4 HOSPITAL PLZ, SUITE 304, CLARKSBURG, WV 26301-9327
(304) 624-7111
(304) 624-9267
Mailing address
4 HOSPITAL PLZ, SUITE 304, CLARKSBURG, WV 26301-9327
(304) 624-7111
(304) 624-9267

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15635
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0071747000
WV
Enumeration date
11/08/2005
Last updated
07/08/2007
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