Provider Demographics
NPI:1619387032
Name:PUREWAL, RUPEENA (MD,)
Entity Type:Individual
Prefix:
First Name:RUPEENA
Middle Name:
Last Name:PUREWAL
Suffix:
Gender:F
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:P.O. BOX 9186
Mailing Address - Street 2:1 MEDICAL CENTER DRIVE, ROOM 4601
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506
Mailing Address - Country:US
Mailing Address - Phone:304-293-7542
Mailing Address - Fax:304-293-5709
Practice Address - Street 1:1 MEDICAL CENTER DRIVE, ROOM 4601
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506
Practice Address - Country:US
Practice Address - Phone:304-293-7542
Practice Address - Fax:304-293-5709
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program