Provider Demographics
NPI:1215285911
Name:POPA, RAZVAN GABRIEL
Entity type:Individual
Prefix:DR
First Name:RAZVAN
Middle Name:GABRIEL
Last Name:POPA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 KANAWHA TPKE
Mailing Address - Street 2:APT 10A
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-2219
Mailing Address - Country:US
Mailing Address - Phone:304-553-8322
Mailing Address - Fax:
Practice Address - Street 1:173 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:WV
Practice Address - Zip Code:25043-0789
Practice Address - Country:US
Practice Address - Phone:304-587-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist