Healthcare Provider Details

I. General information

NPI: 1982104014
Provider Name (Legal Business Name): NONES DIA CARDIAC SYSTEMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 MAIN ST W
OAK HILL WV
25901-3414
US

IV. Provider business mailing address

803 SEMINOLE CIR
MOUNT HOPE WV
25880-8811
US

V. Phone/Fax

Practice location:
  • Phone: 681-207-2055
  • Fax:
Mailing address:
  • Phone: 606-224-1740
  • Fax: 681-207-1811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: OLAWALE O OLATUNJI
Title or Position: PRESIDENT
Credential: MD
Phone: 606-224-1740