Individual
DR. TAMEJIRO TAKUBO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4619 KANAWHA AVE SW, SOUTH CHARLESTON, WV 25309-1319
(304) 400-4545
(304) 400-4546
Mailing address
4619 KANAWHA AVE SW, SOUTH CHARLESTON, WV 25309-1319
(304) 400-4545
(304) 400-4546
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
1828
WV
207RP1001X
Pulmonary Disease Physician
1828
WV
Other
Enumeration date
07/17/2006
Last updated
01/30/2020
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