Individual
DR. GAURAV PRABHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ROBERT C. BYRD CLINICAL TRAINING CENTER, 4TH FLOOR, 3200 MACCORKLE AVENUE SOUTHEAST, CHARESTON, WV 25304
(304) 388-5510
Mailing address
ROBERT C. BYRD CLINICAL TRAINING CENTER, 4TH FLOOR, 3200 MACCORKLE AVENUE SOUTHEAST, CHARESTON, WV 25304
(304) 388-5590
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/08/2019
Last updated
04/12/2019
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