Healthcare Provider Details

I. General information

NPI: 1386734051
Provider Name (Legal Business Name): NESTOR F DANS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 CHESTERFIELD AVE SUITE 302
CHARLESTON WV
25304-1062
US

IV. Provider business mailing address

PO BOX 4586
CHARLESTON WV
25364-4586
US

V. Phone/Fax

Practice location:
  • Phone: 304-352-2112
  • Fax: 304-352-2113
Mailing address:
  • Phone: 304-352-2112
  • Fax: 304-352-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number20189
License Number StateWV

VIII. Authorized Official

Name: DR. NESTOR F DANS
Title or Position: OWNER
Credential: MD
Phone: 304-352-2112