Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 10054 | WV |
NPI | 1033308994 |
---|---|
Provider Name | George Zaldivar |
First Address | Charleston, WV 25304-1230 |
Second Address | Charleston, WV 25304-1230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2007 |
Last Update Date | 17/10/2007 |