Dicristofaro, Sean Charles
Dicristofaro, Sean Charles is an sole proprietor health care provider with primary practice located at 104 Station Place Way , Hurricane WV 25526-8747. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Dicristofaro, Sean Charles can be contacted via phone (304) 757-7788.Contact Information
Primary practice address
104 Station Place Way
Hurricane WV 25526-8747
Phone: (304) 757-7788
Fax: (304) 201-1140
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | WV19679 | West Virginia |
Profile Details
| NPI number | 1053370056 |
|---|---|
| LBN Legal business name | Dicristofaro, Sean Charles |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 20th, 2006 |
| Last updated | Nov 12th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053370056 | NPPES |
| West Virginia | MEDICAID | 5630468000 |
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