| Dr Petaiah Mohan, MD | |
|
194 Carriage Dr, Beckley, WV 25801-2804 | |
| (304) 255-6051 | |
| (304) 255-6051 |
| Full Name | Dr Petaiah Mohan |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Neonatal-perinatal Medicine |
| Location | 194 Carriage Dr, Beckley, West Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033295324 | NPI | - | NPPES |
| 0110044000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 18400 (West Virginia) | Primary |
| Entity Name | Appalachian Regional Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477510162 PECOS PAC ID: 0840107835 Enrollment ID: O20031210000688 |
| Entity Name | Raleigh General Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114475746 PECOS PAC ID: 6103735154 Enrollment ID: O20040914001132 |
| Entity Name | Appalachian Mountains Medical Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881023117 PECOS PAC ID: 6709016264 Enrollment ID: O20140228000564 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Petaiah Mohan, MD 1710 Harper Rd, Beckley, WV 25801-3357 Ph: (304) 255-6051 | Dr Petaiah Mohan, MD 194 Carriage Dr, Beckley, WV 25801-2804 Ph: (304) 255-6051 |
Carlos Estanislao Lucero, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 403 Carriage Drive, Beckley, WV 25801 Phone: 304-255-7456 Fax: 304-255-5899 | |
Ramon Lacanilao, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30 Mallard Court, Beckley, WV 25801 Phone: 304-255-0800 Fax: 304-255-1040 | |
Kim D Bennett, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 252 Rural Acres Dr, Beckley, WV 25801 Phone: 304-252-8551 Fax: 304-252-1790 | |
Dr. Michele Dawn Staton, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2401 S Kanawha St, Suite 110a, Beckley, WV 25801 Phone: 304-929-4646 Fax: 304-929-4649 | |
Dr. Malik Hamdan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1710 Harper Rd, Beckley, WV 25801 Phone: 304-256-4100 Fax: 304-254-3016 | |
Dr. Saraswathi Mohan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 194 Carriage Dr, Beckley, WV 25801 Phone: 304-255-6051 Fax: 304-255-6051 |