Provider Demographics
NPI:1265726681
Name:KAPOURALES, SUSANNA A (MD)
Entity type:Individual
Prefix:DR
First Name:SUSANNA
Middle Name:A
Last Name:KAPOURALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1600 MEDICAL CENTER DR STE 3500
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3655
Mailing Address - Country:US
Mailing Address - Phone:304-691-1300
Mailing Address - Fax:304-691-1375
Practice Address - Street 1:300 CORPORATE CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560
Practice Address - Country:US
Practice Address - Phone:304-691-8870
Practice Address - Fax:304-691-6751
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2021-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV25680208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics