Provider Demographics
NPI:1306055827
Name:ASAITHAMBI, GANESH (MD)
Entity type:Individual
Prefix:DR
First Name:GANESH
Middle Name:
Last Name:ASAITHAMBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 HARPER RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3366
Mailing Address - Country:US
Mailing Address - Phone:681-207-7130
Mailing Address - Fax:681-207-7132
Practice Address - Street 1:1832 HARPER RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3366
Practice Address - Country:US
Practice Address - Phone:681-207-7129
Practice Address - Fax:681-207-7132
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24076207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease