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General NPI Number Information
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NPI Number | 1770069163
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Entity Type | Organization
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Legal Business Name | DEMBAL HEART & VASCULAR PLLC
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 427 CARRIAGE DR
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City | BECKLEY
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State | WV
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Zip | 25801-2805
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Country | US
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Telephone | 304-241-2796
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Fax | 681-207-1811
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Provider Business Mailing Address
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Address Line | 226 TIMBER RIDGE DR
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City | BECKLEY
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State | WV
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Zip | 25801-3655
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Country | US
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Telephone | 646-515-9639
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELAKU DEMEDE
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Credential | MD
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Telephone | 646-515-9639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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