Healthcare Provider Details

I. General information

NPI: 1184653396
Provider Name (Legal Business Name): THOMAS J PIEHOWICZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 VALLEY DR
POINT PLEASANT WV
25550-2031
US

IV. Provider business mailing address

PO BOX 840
LIMA OH
45802-0840
US

V. Phone/Fax

Practice location:
  • Phone: 304-675-4340
  • Fax: 304-675-5893
Mailing address:
  • Phone: 877-574-7116
  • Fax: 419-223-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34002974
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1850
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: