Individual
PERATHU KANNU RAKESH MANIVANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 MORRIS STREET, CHARLESTON, WV 25301
(304) 388-5432
(304) 388-3604
Mailing address
400 ASSOCIATION DRIVE, SUITE 102, CHARLESTON, WV 25311
(304) 760-7536
(304) 760-7540
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31337
WV
Other
Enumeration date
03/26/2019
Last updated
10/28/2025
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