Provider Demographics
NPI:1851338446
Name:GUHA, SOMES (MD)
Entity Type:Individual
Prefix:
First Name:SOMES
Middle Name:
Last Name:GUHA
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 1:5314 MAC CORKLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304
Mailing Address - Country:US
Mailing Address - Phone:304-925-1050
Mailing Address - Fax:304-925-0581
Practice Address - Street 1:5314 MAC CORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304
Practice Address - Country:US
Practice Address - Phone:304-925-1050
Practice Address - Fax:304-925-0581
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20961207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2003573000Medicaid
H36271Medicare UPIN
WV2003573000Medicaid