Provider Demographics
NPI:1114914280
Name:KHURANA, AMAR N (MD)
Entity Type:Individual
Prefix:DR
First Name:AMAR
Middle Name:N
Last Name:KHURANA
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 1:485 COLLIERS WAY
Mailing Address - Street 2:SUITE E
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062
Mailing Address - Country:US
Mailing Address - Phone:304-723-6100
Mailing Address - Fax:304-723-6160
Practice Address - Street 1:485 COLLIERS WAY
Practice Address - Street 2:SUITE E
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062
Practice Address - Country:US
Practice Address - Phone:304-723-6100
Practice Address - Fax:304-723-6160
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16329207R00000X
OH35070360207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2122714Medicaid
WV0074851000Medicaid
WV0720434Medicare PIN
WV080907Medicare PIN
WV0074851000Medicaid
WVF23169Medicare UPIN
OH2122714Medicaid