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General NPI Number Information
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NPI Number | 1144317082
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Entity Type | Organization
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Legal Business Name | WILFREDO N. MOLANO MDSC INC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 2733 MAIN ST
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City | HURRICANE
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State | WV
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Zip | 25526-1420
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Country | US
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Telephone | 304-562-3331
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | HURRICANE
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State | WV
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Zip | 25526
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Country | US
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Telephone | 304-562-3331
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Fax | 304-562-3364
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Authorized Official
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Title or Position | PHYSICIAN/ADMINISTRATOR
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Name | DR. WILFREDO NAVA MOLANO
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Credential | M.D.
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Telephone | 304-562-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 10473
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License Number State | WV
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