Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0116027393 | VA |
Y | 111NI0900X | Internist | 0116027393 | VA |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 3157 | WV |
NPI | 1518372036 |
---|---|
Provider Name | Victoria Fasick |
First Address | Parkersburg, WV 26101-5340 |
Second Address | Parkersburg, WV 26101-5340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2014 |
Last Update Date | 29/03/2018 |