Provider Demographics
NPI:1245488279
Name:MONONGALIA RADIOLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:MONONGALIA RADIOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SURENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-598-1297
Mailing Address - Street 1:224 PENN AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-2154
Mailing Address - Country:US
Mailing Address - Phone:412-247-4543
Mailing Address - Fax:412-247-4550
Practice Address - Street 1:1200 J D ANDERSON DR
Practice Address - Street 2:MONONGALIA GENERAL HOSPITAL
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3494
Practice Address - Country:US
Practice Address - Phone:304-598-1297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty