NPI 1447909346 · live from the CMS NPI Registry
Phonphanh Dedthanou, DO
Psychiatry & Neurology, Neurology in Morgantown, WV. National Provider Identifier 1447909346, active.
NPI record
| NPI | 1447909346 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 1 Medical Center Dr, 1310 Hsc, Morgantown, WV 26506 |
| Practice phone | 304-293-2342 |
| Mailing address | 130 Red Mulberry Way Apt 2, Charleston, WV 25306 |
| Enumerated | March 20, 2022 |
| Last updated | June 4, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | MED-PHYS-LIC-173223 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.