Provider Demographics
NPI:1124434550
Name:AYNAMPUDI, ACHUTA RAM (MD)
Entity type:Individual
Prefix:
First Name:ACHUTA
Middle Name:RAM
Last Name:AYNAMPUDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 STONEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-1589
Mailing Address - Country:US
Mailing Address - Phone:304-285-5400
Mailing Address - Fax:304-285-5401
Practice Address - Street 1:100 STONEY HILL RD
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554
Practice Address - Country:US
Practice Address - Phone:304-285-5400
Practice Address - Fax:304-285-5401
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV280612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry