Provider Demographics
NPI:1437204831
Name:OHIO VALLEY ASTHMA & ALLERGY INSTITUTE INC
Entity Type:Organization
Organization Name:OHIO VALLEY ASTHMA & ALLERGY INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:URVAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-234-8912
Mailing Address - Street 1:2101 JACOB ST STE 601
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3844
Mailing Address - Country:US
Mailing Address - Phone:304-234-8912
Mailing Address - Fax:304-234-8218
Practice Address - Street 1:40 MEDICAL PARK STE 505
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6392
Practice Address - Country:US
Practice Address - Phone:304-234-8912
Practice Address - Fax:043-234-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16677207K00000X
WV20636207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV16677OtherURVAL'S LICENSE
WV3810006056Medicaid
WV10831754OtherCAQH URVAL
WV3810006056Medicaid
WV10831754OtherCAQH URVAL
WV9244351Medicare ID - Type UnspecifiedGROUP MEDICARE #
WV16677OtherURVAL'S LICENSE
WV3810006056Medicaid