Healthcare Provider Details

I. General information

NPI: 1174681761
Provider Name (Legal Business Name): CVMS SPECIALIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROSS PARK BLVD SUITE 105
STEUBENVILLE OH
43952-2681
US

IV. Provider business mailing address

1 ROSS PARK BLVD SUITE 105
STEUBENVILLE OH
43952-2681
US

V. Phone/Fax

Practice location:
  • Phone: 740-282-8746
  • Fax: 740-282-2800
Mailing address:
  • Phone: 740-282-8746
  • Fax: 740-282-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAYAPAL REDDY
Title or Position: OWNER
Credential: MD
Phone: 740-282-8746