IndividualActive
Bose Mikkilineni, M.D. FACS
NPI 1407840549 · Surgery Physician · Beckley, WV
Provider details
- NPI number
- 1407840549
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D. FACS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 12282 (WV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
419 Carriage Dr
Beckley, WV 25801-2805
Phone: (304) 253-8416
Fax: (866) 461-4726
Approximate (ZIP-level) locationGet directions
Mailing address
419 Carriage Dr
Beckley, WV 25801-2805
Registry dates
- Enumerated
- 2005-09-05
- Last updated
- 2013-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.