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NPI Code Detail

MEDICARE: DIGESTIVE DISEASE CONSULTANTS LLC

MEDICARE: DIGESTIVE DISEASE CONSULTANTS LLC
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
1207RG0100XGastroenterology Physician19873WV

General Provider Information

NPI Number : 1093712168
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIGESTIVE DISEASE CONSULTANTS LLC
Provider Business Mailing Address
First Line : 501 COLLIERS WAY
Second Line : SUITE 301
City : WEIRTON
State : WV
Zip : 26062-5003
Country : US
Telephone Number : 304-723-9606
Fax Number : 304-723-3600
Provider Business Practice Location Address
First Line : 501 COLLIERS WAY
Second Line : SUITE 301
City : WEIRTON
State : WV
Zip : 26062-5003
Country : US
Telephone Number : 304-723-9606
Fax Number : 304-723-3600
Authorized Official
Title or Position : MANAGING PARTNER
Name : DR. AMAN S. PUREWAL
Credential : MD
Telephone Number : 304-723-9606
Provider Enumeration Date : 07/05/2005
Last Update Date : 08/22/2020

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Directions to “DIGESTIVE DISEASE CONSULTANTS LLC ” Practice Location

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