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General NPI Number Information
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NPI Number | 1609061399
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Entity Type | Organization
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Legal Business Name | THEODORE P WERBLIN MD PC
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 1051 STAFFORD DR
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City | PRINCETON
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State | WV
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Zip | 24740-2409
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Country | US
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Telephone | 304-487-6123
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Fax | 304-425-2631
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Provider Business Mailing Address
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Address Line | 1051 STAFFORD DR PO BOX 5879
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City | PRINCETON
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State | WV
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Zip | 24740-2409
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Country | US
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Telephone | 304-487-6123
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Fax | 304-425-2631
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. SARA WERBLIN
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Credential |
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Telephone | 304-487-6123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 12870
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License Number State | WV
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