Provider Demographics
NPI:1427075258
Name:NARASIMHAN, SRINIVASAN (MD)
Entity type:Individual
Prefix:
First Name:SRINIVASAN
Middle Name:
Last Name:NARASIMHAN
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 1:2335 CHESTERFIELD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1066
Mailing Address - Country:US
Mailing Address - Phone:681-265-3820
Mailing Address - Fax:681-265-5031
Practice Address - Street 1:2335 CHESTERFIELD AVE STE 101
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1066
Practice Address - Country:US
Practice Address - Phone:681-265-3820
Practice Address - Fax:681-265-5031
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18444207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0078744000Medicaid
WVP1075672OtherRAILROAD MEDICARE
WVP1075672OtherRAILROAD MEDICARE
F44374Medicare UPIN
WVWV1208AMedicare PIN