Organization
COEBURN CLINIC, INC
Active
Other names
COEBURN HOSPITAL CLINIC, INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GURCHARAN SINGH KANWAL MD (PRESIDENT)
(276) 395-6244
Entity
Organization
Contact information
Practice address
116 CENTER ST, COEBURN, VA 24230-2200
(276) 395-6244
(276) 395-3058
Mailing address
PO BOX 1136, 116 CENTER ST, COEBURN, VA 24230-1136
(276) 395-6244
(276) 395-3058
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101021217
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
NUMBERS
VA
Enumeration date
07/05/2012
Last updated
07/05/2012
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