IndividualActive
Victoria Takubo, PA-C
NPI 1194032227 · Surgical Physician Assistant · South Charleston, WV
Provider details
- NPI number
- 1194032227
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 01484 (WV)
Practice location
4610 Kanawha Ave Sw Ste 401
South Charleston, WV 25309-1367
Phone: (304) 768-7368
Fax: (304) 768-1829
Mailing address
4605 Maccorkle Ave Sw
South Charleston, WV 25309-1311
Registry dates
- Enumerated
- 2010-09-10
- Last updated
- 2022-01-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.