Sokhom Raphael Chan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

19124 Issued in WV

Practice address

VA Medical Center, 1 Medical Center Drive
Clarksburg, WV 26301-4199

Phone

(304) 623-3461

Fax

(304) 623-7666

NPI assigned

Jul 24, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003838186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263014199",
            "telephone_number": "304-623-3461",
            "fax_number": "304-623-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA MEDICAL CENTER, 1 MEDICAL CENTER DRIVE",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263014199",
            "telephone_number": "304-623-3461",
            "fax_number": "304-623-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SOKHOM",
        "middle_name": "RAPHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "19124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central WV Community Action
• Jessica Chadwick
• Angela Jean Chamberlain
• Laurel Victoria Chambers, PHARMD
• Lori Marie Champaign
• Amanda Sue Charlton-Fryer, PSYD
• Thomas Harry Chase
• Jessica Nicole Chatham, BSN, RN
• Lila Chaverra-Catania, LICSW
• Danielle Marie Chefren, M.S.W.

• Psychiatry Physician in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Psychiatry Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.