Udall, John N

Udall, John N is an individual health care provider with primary practice located at 830 Pennsylvania Ave, Suite 103 , Charleston WV 25302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Udall, John N can be contacted via phone (304) 388-1552.

Contact Information

Primary practice address
830 Pennsylvania Ave, Suite 103 Charleston WV 25302
Phone: (304) 388-1552
Fax: (304) 388-1577
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 21878 West Virginia

Profile Details

NPI number 1346341211
LBN Legal business name Udall, John N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jul 8th, 2007 - about 19 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 1346341211 NPPES
West Virginia MEDICAID 3810001803

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