Individual
DR. RAJA GOPAL SUNKAVALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2000 PROFESSIONAL CT STE C, MARTINSBURG, WV 25401-8803
(304) 263-8853
(304) 263-6178
Mailing address
2500 FOUNDATION WAY, MARTINSBURG, WV 25401-9000
(304) 264-9202
(304) 264-9042
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125055068
IL
208000000X
Pediatrics Physician
Primary
26089
WV
208000000X
Pediatrics Physician
66329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810028050
—
WV
01
—
WV4760B987
MEDICARE PTAN
WV
Enumeration date
08/25/2009
Last updated
11/08/2022
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