Provider Demographics
NPI:1134215973
Name:LOHAN, JAMES A (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:LOHAN
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 1:3100 MACCORKLE AVE SE STE 700
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1230
Mailing Address - Country:US
Mailing Address - Phone:304-347-1300
Mailing Address - Fax:
Practice Address - Street 1:1201 WASHINGTON STREET, E
Practice Address - Street 2:SUITE 103
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301
Practice Address - Country:US
Practice Address - Phone:304-388-7270
Practice Address - Fax:304-388-7280
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21187208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00266381OtherRAILROAD MEDICARE
WV3810002342Medicaid
WVLO6033151Medicare ID - Type Unspecified
I31910Medicare UPIN