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General NPI Number Information
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NPI Number | 1194825091
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Entity Type | Organization
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Legal Business Name | THE ENDOCRINOLOGY CLINIC PLLC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 651 COLLIERS WAY SUITE 406
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City | WEIRTON
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State | WV
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Zip | 26062-5053
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Country | US
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Telephone | 304-723-5670
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 SAINT MELLION DR
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City | PRESTO
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State | PA
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Zip | 15142-1009
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Country | US
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Telephone | 304-723-5670
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VIORICA MARIA CRISAN
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Credential | MD
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Telephone | 304-723-6570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 20464
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License Number State | WV
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