1932305232 NPI number — DR. KOKAB CHRISTINA DARBANDI M.D.

Table of content: DR. KOKAB CHRISTINA DARBANDI M.D. (NPI 1932305232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932305232 NPI number — DR. KOKAB CHRISTINA DARBANDI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DARBANDI
Provider First Name:
KOKAB
Provider Middle Name:
CHRISTINA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932305232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9160
Provider Second Line Business Mailing Address:
1 MEDICAL CENTER DRIVE
Provider Business Mailing Address City Name:
MORGANTOWN
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26506-9160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-293-1964
Provider Business Mailing Address Fax Number:
304-293-2544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 MEDICAL CENTER DRIVE
Provider Second Line Business Practice Location Address:
PHYSICIANS OFFICE CENTER
Provider Business Practice Location Address City Name:
MORGANTOWN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-293-1964
Provider Business Practice Location Address Fax Number:
304-293-2544
Provider Enumeration Date:
06/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 23649 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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