Cruzzavala, Jose

Cruzzavala, Jose is an individual health care provider with primary practice located at 600 18Th Street Suite 201, Parkersburg WV 26101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Cruzzavala, Jose can be contacted via phone (304) 424-4760.

Contact Information

Primary practice address
600 18Th Street Suite 201 Parkersburg WV 26101
Phone: (304) 424-4760
Fax: (304) 424-4761
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 15479 West Virginia

Profile Details

NPI number 1629162342
LBN Legal business name Cruzzavala, Jose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Oct 13th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629162342 NPPES
West Virginia MEDICAID 0129506000
West Virginia Other 020045089

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