Basic Information
| Provider Information | |||||||||
| NPI: | 1891434775 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SURI | ||||||||
| FirstName: | MEGHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 PENNSYLVANIA AVE., CHARLESTON, WV 25302 | ||||||||
| Address2: | FAMILYCARE/CHILDREN'S MEDICINE CENTER | ||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044141880 | ||||||||
| FaxNumber: | 3044141886 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 PENNSYLVANIA AVE., CHARLESTON, WV 25302 | ||||||||
| Address2: | FAMILYCARE/CHILDREN'S MEDICINE CENTER | ||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044141880 | ||||||||
| FaxNumber: | 3044141886 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2022 | ||||||||
| LastUpdateDate: | 08/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.