Individual
VLADIMER BAKHUTASHVILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 STADIUM DR, MORGANTOWN, WV 26506-7911
(304) 598-4850
(304) 598-4871
Mailing address
101 STADIUM DR, MORGANTOWN, WV 26506-7911
(304) 598-4850
(304) 598-4871
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
25MA11938600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2018
Last updated
07/13/2023
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