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Individual

VETTIVELU MAHESWARAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1212 N MILDRED ST, RANSON, WV 25438-5552
(304) 724-6091
Mailing address
1212 N MILDRED ST, RANSON, WV 25438-5552
(304) 724-6091

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01028
WV
207V00000X
Obstetrics & Gynecology Physician
Primary
10753
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01028
WEST VIRGINIA BOARD OF MEDICAL EXAMINERS VOLUNTEER PROVIDER NUMBER
WV
01
10753
THE MEDICAL LICENSING BOARD OF WEST VIRGINIA
WV
Enumeration date
02/18/2014
Last updated
03/25/2014
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