Healthcare Provider Details

I. General information

NPI: 1386183473
Provider Name (Legal Business Name): GIAIMO MOBILE PODIATRY OF WV PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 WASHINGTON ST W
CHARLESTON WV
25302-2348
US

IV. Provider business mailing address

4350 BROWNSBORO RD STE 210
LOUISVILLE KY
40207-1681
US

V. Phone/Fax

Practice location:
  • Phone: 248-528-1981
  • Fax: 614-416-2105
Mailing address:
  • Phone: 248-528-2116
  • Fax: 502-996-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1044
License Number StateWV

VIII. Authorized Official

Name: JOY L STEVENS
Title or Position: VP OF REVENUE ASSURANCE
Credential:
Phone: 502-244-2441