| Modi Medical Corporation | |
|
4605 Maccorkle Ave Sw Ste 302 South Charleston WV 25309-1311 | |
| (304) 204-2430 | |
| (304) 397-6740 |
| Full Name | Modi Medical Corporation |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 4605 Maccorkle Ave Sw Ste 302, South Charleston, West Virginia |
| Authorized Official Name and Position | Jignesh J Modi (PRESIDENT) |
| Authorized Official Contact | 3042042430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modi Medical Corporation 40 Fairland Drive Nitro WV 25143 Ph: (304) 204-2430 | Modi Medical Corporation 4605 Maccorkle Ave Sw Ste 302 South Charleston WV 25309-1311 Ph: (304) 204-2430 |
| NPI Number | 1528178076 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 10/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528178076 | NPI | - | NPPES |
| 9341491 | Other | PTAN | |
| 0300025000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 19795 (West Virginia) | Primary |
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