Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 11677 | WV |
N | 111NI0900X | Internist | 11677 | WV |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 11677 | WV |
N | 207U00000X | Nuclear Medicine Specialist | 11677 | WV |
NPI | 1043275662 |
---|---|
Provider Name | Bruce S Chertow |
First Address | Huntington, WV 25701-3656 |
Second Address | Huntington, WV 25701-3656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0082914000 | (05) | WV |
0414028 | (05) | OH |
64693815 | (05) | KY |
A72035 | (02) | WV |