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General NPI Number Information
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NPI Number | 1104670272
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Entity Type | Individual
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Provider Name | ADRIANA D SEVY PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 800 GRAND CENTRAL MALL STE 11
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City | VIENNA
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State | WV
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Zip | 26105-4100
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Country | US
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Telephone | 304-424-4150
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Fax |
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Provider Business Mailing Address
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Address Line | 217 WALNUT DR
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City | MARIETTA
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State | OH
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Zip | 45750-1060
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Country | US
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Telephone | 740-350-6001
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2941
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License Number State | WV
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