Provider Demographics
NPI:1215177928
Name:CHURA-SINGH, KELLY A (DO)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:A
Last Name:CHURA-SINGH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1418 MACCORKLE AVE SW STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1331
Mailing Address - Country:US
Mailing Address - Phone:304-348-1288
Mailing Address - Fax:304-348-1262
Practice Address - Street 1:1418 MACCORKLE AVE SW STE A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1331
Practice Address - Country:US
Practice Address - Phone:304-348-1288
Practice Address - Fax:304-348-1262
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry