1538237193 NPI number — MR. DIOSDADO A GARCIA MD

Table of content: MR. DIOSDADO A GARCIA MD (NPI 1538237193)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538237193 NPI number — MR. DIOSDADO A GARCIA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
DIOSDADO
Provider Middle Name:
A
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538237193
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 MARKET ST
Provider Second Line Business Mailing Address:
SUITE 1000
Provider Business Mailing Address City Name:
STEUBENVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43952-2881
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-284-1775
Provider Business Mailing Address Fax Number:
740-284-1749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 1100
Provider Business Practice Location Address City Name:
STEUBENVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43952-2881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-282-1624
Provider Business Practice Location Address Fax Number:
740-282-1679
Provider Enumeration Date:
12/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD031183L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0200X , with the licence number: MD031183L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 35041328 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0084609000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0253470 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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