Provider Demographics
NPI:1316001928
Name:R SAMPATH MD INC
Entity type:Organization
Organization Name:R SAMPATH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMANATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMPATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-345-4031
Mailing Address - Street 1:3100 MACCORKLE AVENUE SE
Mailing Address - Street 2:SUITE 904
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304
Mailing Address - Country:US
Mailing Address - Phone:304-345-4031
Mailing Address - Fax:304-344-0328
Practice Address - Street 1:3100 MACCORKLE AVENUE SE
Practice Address - Street 2:SUITE 904
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304
Practice Address - Country:US
Practice Address - Phone:304-345-4031
Practice Address - Fax:304-344-0328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty