Provider Demographics
NPI:1386639243
Name:CURNUTTE, LARRY DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:DOUGLAS
Last Name:CURNUTTE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4501 MACCORKLE AVE SW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1444
Mailing Address - Country:US
Mailing Address - Phone:304-766-9600
Mailing Address - Fax:304-766-9606
Practice Address - Street 1:4501 MACCORKLE AVE SW
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1444
Practice Address - Country:US
Practice Address - Phone:304-766-9600
Practice Address - Fax:304-766-9606
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV8869207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0093599000Medicaid
WV0093599000Medicaid
B42488Medicare UPIN