Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 26928 | WV |
N | 207RI0011X | Interventional Cardiology | 59498 | AZ |
NPI | 1053541797 |
---|---|
Provider Name | Dr. Luis Alejandro Asencio Magdaleno |
First Address | Beckley, WV 25801-3373 |
Second Address | Beckley, WV 25801-3373 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2009 |
Last Update Date | 03/02/2020 |