| NPI | 1952590432 |
|---|---|
| Former Legal Business Name | VIJAYKUMAR R. PHADE MD |
| Entity Type | Organization |
| Authorized Contact | VIJAYKUMAR R PHADE President 304-327-7476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 12519) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: WV 12519) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2008-07-16 |