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CENTRAL WV DERM ASSOC INC NPI 1669583589


NPI Information

NPI: 1669583589
Provider Name: CENTRAL WV DERM ASSOC INC
Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
170 THOMPSON DR
SUITE 200
BRIDGEPORT, WV
ZIP 26330
Phone: (304) 842-3494
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CENTRAL WV DERM ASSOC INC is a dermatology in Bridgeport, WV. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. CENTRAL WV DERM ASSOC INC NPI is 1669583589. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

170 THOMPSON DR
SUITE 200
BRIDGEPORT, WV
ZIP 26330-608
Phone: (304) 842-3494
Fax: (304) 842-2339

The provider's authorized official is Georgia Dawn Daniel .
The authorized official title is Chief Operating Officer and has the following contact phone number (304) 842-3494.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 9/10/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DD9600MEDICARE PINWEST VIRGINIA
21019121420001MEDICAIDPENNSYLVANIA
39356591MEDICARE PINOHIO
4107701V46MEDICARE PINPENNSYLVANIA
53810003851MEDICAIDWEST VIRGINIA
69356581MEDICARE PINWEST VIRGINIA
72624968MEDICAIDOHIO
82624959MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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