| Jefferson Med-peds Inc | |
|
207 E 5th Ave Ranson WV 25438-1613 | |
| (304) 279-1372 | |
| (304) 728-3623 |
| Full Name | Jefferson Med-peds Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 207 E 5th Ave, Ranson, West Virginia |
| Authorized Official Name and Position | Vikram Dayal (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3042791372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Med-peds Inc 207 E 5th Ave Ranson WV 25438-1613 Ph: (304) 279-1372 | Jefferson Med-peds Inc 207 E 5th Ave Ranson WV 25438-1613 Ph: (304) 279-1372 |
| NPI Number | 1568400901 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 12/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568400901 | NPI | - | NPPES |
| 0073128000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 16223 (West Virginia) | Primary |
| 208000000X | Pediatrics | 16223 (West Virginia) | Secondary |
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