Healthcare Provider Details

I. General information

NPI: 1275130833
Provider Name (Legal Business Name): DANIEL BIAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 5TH AVE
HUNTINGTON WV
25701-1908
US

IV. Provider business mailing address

540 5TH AVE
HUNTINGTON WV
25701-1908
US

V. Phone/Fax

Practice location:
  • Phone: 304-697-0022
  • Fax: 304-697-8556
Mailing address:
  • Phone: 304-697-0022
  • Fax: 304-697-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number171M00000X
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: