MEDICARE: MS. CHRISTINA TERRI DIMECH M.D.

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	33553	WV
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1093276180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA TERRI DIMECH M.D.

Provider Business Mailing Address
First Line	:	1421 COMMERCE ST
Second Line	:
City	:	WELLSBURG
State	:	WV
Zip	:	26070-1320
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 COMMERCE ST
Second Line	:
City	:	WELLSBURG
State	:	WV
Zip	:	26070-1320
Country	:	US
Telephone Number	:	304-737-0816
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2019
Last Update Date	:	07/10/2024

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