Basic Information
| Provider Information | |||||||||
| NPI: | 1578124624 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VOORE | ||||||||
| FirstName: | VISHWADHIPA | ||||||||
| MiddleName: | VENKATA | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 NORTH WASHINGTON AVENUE, THE WRIGHT CENTER FOR GRAD | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SCRANTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703432383 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1710 HARPER RD | ||||||||
| Address2: | |||||||||
| City: | BECKLEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 258013357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042564100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2019 | ||||||||
| LastUpdateDate: | 10/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 31617 | WV | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.