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NPI Code Detail

MEDICARE: R.TODD DEPOND, MD, PLLC

MEDICARE: R.TODD DEPOND, MD, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VG0400XGynecology Physician16935WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11205804374OTHERWVNPI NUMBER

General Provider Information

NPI Number : 1083656516
Entity Type Code : Organization
Provider Name (Legal Business Name) : R.TODD DEPOND, MD, PLLC
Provider Business Mailing Address
First Line : 400 COURT ST
Second Line :
City : CHARLESTON
State : WV
Zip : 25301-1652
Country : US
Telephone Number : 304-345-4525
Fax Number : 304-345-4527
Provider Business Practice Location Address
First Line : 400 COURT ST
Second Line : SUITE 100
City : CHARLESTON
State : WV
Zip : 25301-1652
Country : US
Telephone Number : 304-345-4525
Fax Number : 304-345-4527
Authorized Official
Title or Position : OWNER
Name : DR. ROBERT TODD DEPOND
Credential :
Telephone Number : 304-345-4525
Provider Enumeration Date : 06/11/2006
Last Update Date : 08/22/2020

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