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General NPI Number Information
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NPI Number | 1205885308
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Entity Type | Individual
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Provider Name | ISABEL CRISTINA DELTORO GORDINHO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 07/10/2015
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Provider Practice Location Address
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Address Line | 2962 ROBERT C. BYRD DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801
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Country | US
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Telephone | 304-254-9022
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Fax | 304-254-9024
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Provider Business Mailing Address
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Address Line | 2962 ROBERT C. BYRD DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801
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Country | US
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Telephone | 304-254-9022
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Fax | 304-254-9024
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 0101056752
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 20422
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License Number State | WV
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