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General NPI Number Information
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NPI Number | 1144499401
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Entity Type | Organization
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Legal Business Name | SIDNEY C. LERFALD, MD
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 415 MORRIS ST SUITE 306
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City | CHARLESTON
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State | WV
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Zip | 25301-1842
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Country | US
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Telephone | 304-343-1022
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Fax | 304-720-8286
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Provider Business Mailing Address
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Address Line | 415 MORRIS ST SUITE 306
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City | CHARLESTON
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State | WV
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Zip | 25301-1842
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Country | US
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Telephone | 304-343-1022
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Fax | 304-720-8286
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Authorized Official
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Title or Position | OWNER
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Name | SIDNEY C. LERFALD
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Credential | MD
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Telephone | 304-343-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10824
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License Number State | WV
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