NPI 1053468900

Marion Lung Clinic

Organisation Pulmonary Disease Physician Fairmont, WV

Practice location

Address: 1325 Locust Ave Suite 35, Fairmont, WV 26554-1435
Phone: (304) 363-7773
Fax: (304) 363-7773

Authorised official

Name: Prasad V Devabhaktuni
Title: Owner
Phone: (304) 363-7773

Registered specialties

Pulmonary Disease Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207RP1001X

Other Internal Medicine providers in West Virginia →

Registry record

NPI: 1053468900
Entity type: Organization
NPI issued: 4 Jan 2007
Record last updated: 6 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.