Basic Information
| Provider Information | |||||||||
| NPI: | 1386841518 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BISWAS | ||||||||
| FirstName: | RONBIR | ||||||||
| MiddleName: | MUKHERJEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 MORRIS ST | ||||||||
| Address2: | STE 357 | ||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253011326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042937401 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3110 MACCORKLE AVE SE | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253041210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043471220 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 04/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 2321 | WV | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 2321 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 2321 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 208M00000X | 2321 | WV | N | Allopathic & Osteopathic Physicians | Hospitalist | 2084A2900X | 2321 | WV | Y |
No ID Information.